Berlin Heart EXCOR Pediatric VAD, Manual, Page: 171 / 250

Chapter 13 Weaning and Explantation for BTR and BTT
25 / 30 ml pump Weaning Sequence
Day 3
After confirmation of eligibility criteria, the following steps should be
performed under echo guidance:
1
1. Administer UFH 75 units/kg x _____ kg = _____ mg IV x 1 [max 5000
units].
2. After 5 minutes, reduce the pump rate step-wise from RR2 (___ bpm)
to 30 bpm in increments of 5 bpm q 5 min. After 5 minutes at 30 bpm,
reassess LV size and function.
3. Initiate exercise with gentle age-appropriate play tasks (e.g. patty
cake) as clinically appropriate, where possible
4. After a total time of 30 min at 30 bpm, stop the pump for 10 min and
reassess LV size and function. During pump stoppage, use the
manual pump to pump twice q30 seconds to minimize the risk of
thrombus formation due to blood stagnation while Ikus is
disconnected.
5. After 10-minute pump stop, reconnect pump to Ikus and resume
pumping at RR3 (___ bpm).
Did the patient satisfy all 5 eligibility criteria
throughout the period of weaning and pump
stoppage?
ÿ
NO - STOP
ÿ
YES -
Proceed
MD________
Da
y 4
After confirmation of eligibility criteria, the following steps should be
performed under echo guidance:
1
1. Administer UFH 75 units/kg x _____ kg = _____ mg IV x 1 [max 5000
units].
2. After 5 minutes, reduce pump rate step-wise from RR
3
(___ bpm) to
30 bpm in increments of 5 bpm q 5 min. After 5 minutes at 30 bpm,
reassess LV size and function.
3. Initiate exercise with gentle age-appropriate play tasks (e.g. patty
cake) as clinically appropriate, where possible.
4. After a total time of 30 min at 30 bpm, stop the pump for 15 min and
reassess LV size and function. During pump stoppage, use the
manual pump to pump twice q30 seconds to minimize the risk of
thrombus formation due to blood stagnation while Ikus is
disconnected.
5. After a 15-minute pump stop: If the patient meets all eligibility criteria,
reconnect pump to Ikus and resume pumping at WR (40 bpm). If the
patient does not meet all criteria, reconnect Ikus and resume
pumping at IR.
Did the patient satisfy all 5 eligibility criteria
throughout the period of weaning and pump
stoppage?
ÿ
NO - STOP
ÿ
YES -
Proceed
MD________
Tab. 13-6 25 / 30 ml pump Weaning Sequence
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