THIS MONTH'S FOCUS:
MECHANICAL CIRCULATORY SUPPORT
NURSING, HEALTH SCIENCES & ALLIED HEALTH
Many thanks to Evgenij Potapov and Emily Stimpson (MCS and NHSAH Council Links Liaisons) for coordinating the focus content for this issue.
EVGENIJ'S ZWEI EURO:
The Role of Nurses in the MCS Field and the Role of MCS in Nursing
In this issue of the Links we have interwoven essays from the MCS and Nursing councils. Why? In the MCS field VAD coordinators play a very important role, no less important than in the transplant field, as Eric Hobson from Philadelphia explains in his essay. With the increased complexity of VAD systems and the large amount of information created, stored and potentially available for analysis, bioengineers have stepped into the forefront in the MCS field. On the other hand, classic nursing tasks such as dressing change are reduced with the current systems, due to lower driveline infection rates than with extracorporeal or implantable pulsatile systems, and will be eliminated altogether with transcutaneous energy transfer in the future.
So, we are following the role changes in the MCS field-from nursing to management and from dressing change to data analysis. One such example is provided by a bioengineer from our center, Friedrich Kaufmann. He writes in particular about sound analysis to detect pump thrombosis. Since last year, we no longer perform pump exchange before getting positive results of sound analysis (in particular for HeartWare HVAD) and technical data from the pumps. This analysis is documented and stored electronically in the official patient file. Pamela S. Combs calls it "shared decision-making" in her essay, and this is the only way to translate different information about the new system—"machine-human interaction"—into a decision. However, there is no shared responsibility in such a case: the decision to exchange the pump or not remains strictly the domain of the operating surgeon.
Evgenij Potapov, MD
Links Communications Liaison, MCS Council
IN THE SPOTLIGHT:
ISHLT 2014 in Sunsational San Diego!
This article features highlights from the 34th Annual Meeting and ISHLT Academies related to Mechanical Circulatory Support and Nursing, Health Sciences & Allied Health. Find out which sessions will be of most interest to you, and plan your trip to San Diego TODAY! Read more →
FOCUS ON MCS AND NURSING:
The Sound of Music ...
by Eric Hobson
A former colleague uses the analogy of an orchestra when she defines the roles and relationships staff fulfill and maintain in the care of transplant patients. Taking this orchestra analogy a bit further, by defining the roles and care design systems familiar to the members of the Society, we will focus on just a few sections of the orchestra. It seems fitting to assign the pulmonary system the brass section, as the instruments in this section rely on "wind" to produce their music. While the cardiac system could be assigned the percussion section, accepting that the "beat of life" is carried on by the drums. Read more →
Personalized Immune Cocktails For Heart Recovery
by Julia Kzhyshkowska
Individualized macrophage phenotype modulation offers us a unique opportunity to design implant-based therapy in a personalized way (compare it to personalizing your smart phone!). In order to avoid disappointing results with blocking of single cytokine functions (as was the case with a TNF-alpha therapy) elegant cocktails of cytokines, growth factors and blocking antibodies have to be prepared for each individual patient. This is not a short-cut to making profits for industry, rather it is the only way to save the most valuable resource we have-human life. Read more →
The Role of the Biomedical Engineer in the Clinic
by Friedrich Kaufmann
Hospitals employ a wide variety of engineers to guarantee the smooth day-to-day running of patient care, diagnostics and treatment - from building services engineers to electrical engineers, IT engineers, medical technology engineers, and so on. Of course, physicians too are skilled in the use of their specialist equipment: the echocardiography specialist is familiar with the features and the technology of his Doppler device. Company technicians are there to provide any additional tool, knowledge or help required. The unique role of the biomedical engineer is to form an interdisciplinary link between the physician and his respective technical environment. Read more →
Shared Decision-Making: Its Involvement in the World of VADs
by Pam Combs
The traditional style of medical decision-making has primarily been the physician making the final selection of the appropriate treatment for the patient's condition. This approach is being challenged by the concept of "shared decision-making." Shared decision-making incorporates education provided to the patient and the caregiver by the health care team, along with the patient's perspective of his/her health care, resulting in the implementation of the agreed-upon plan of care. Read more →
Time To Fall In Love With ECHO
by Evgenij Potapov and Thomas Krabatsch
There is no need to explain here that VAD technology is good. At least, not to us. But there is a huge need to explain it to others. How can this best be done? These days every other cardiac surgery department that implants VADs organizes some kind of VAD meeting. Meanwhile, the main VAD meetings such as the ISHLT and ASAIO annual conferences, the MCS Meeting in Berlin, and the EUMS meetings are attracting more and more attendees. Read more →
OF SPECIAL INTEREST:
The Problems and Pitfalls of Recruitment - Part IV: Search Committee Follies
by Roger Evans
In one way or another, most of us have had an encounter with a search committee. We may have participated as a search committee member or, more likely, in the process of being recruited, our talent has been subjected to the scrutiny of a search committee. Some search committees are better than others, but all must deal with a fairly defined set of issues concerning the selection process and the qualifications of potential candidates. Objectivity shouldn't be an issue but, more often than not, it is a very serious matter that is intentionally overlooked. Read more →
by Monica Colvin-Adams
The 12th Banff Conference on Allograft Pathology was held in Comandatuba-Bahia, Brazil this year. After 2 flights, a one-hour car ride, and a ferry, we arrived on the beautiful, heavily palm-treed island of Comandatuba. Scuttled away amidst the monkeys and the ocean, my memories of Minnesota faded away as I planned my new career tie-dying beach coverups. But our determined leader, Rene Rodriguez, brought us back to reality as the goal of the tropical trip was to work. And so we did. Read more →
OUTTA THIS WORLD LINKS:
Interesting, Inspiring and Intriguing Links from Around the Globe
Read about the world's first artificial heart transplant patient (France), the Guiness World Record for longest living heart transplant patient (United Kingdom), a cancer survivor and heart transplant recipient who completed an Ironman Triathlon (putting everyone else's new year's resolutions to shame), and inspiring stories of love, strength and courage from Ireland and the United States. Read more →
ISHLT Members in the News
Incredible stories featuring some of our ISHLT members from all over the world have been found in the news this month: Peter Hopkins (Australia), Shaf Keshavjee and Dave Nagpal (Canada), Alla GK Gokhale (India), Richard Kirk (United Kingdom), Gonzo Gonzalez, Asghar Khaghani, Alan Gass, Dan Meyer, Jay Bhama, Gregory Perens, Edward Stephenson, Jeff Dreyer and Michael McGrath (United States). Read more →
Smart & Tart Wisdom
by Dan Dilling
In honor of our new year, we offer some smart and tart wisdom from a few greats to tickle your funny bone and to remind you not to take life too seriously! Read more →
NEWS AND ANNOUNCEMENTS:
ISHLT Grants and Awards Applications Are Online - DEADLINE JANUARY 15, 2014!
The 2014 ISHLT Grants and Awards applications are available online at www.ishlt.org/awards. Deadline for receipt of applications is Wednesday, January 15, 2014. Grants will be awarded at the ISHLT 34th Annual Meeting and Scientific Sessions, April 10-13, 2014 in San Diego, California.
A Letter from Across the Pond
by Paul Corris
The UK braced itself this Christmas for wind and rain and with the inclement weather duly arriving, experienced floods and wind damage particularly in the south west. Perhaps the weather was reflecting a rather tumultuous year in many respects and you may recall my letter from June where I indicated that all was not necessarily well with Nye Bevan's baby, the newly reformed NHS. A potential winter crisis looms with many forecasting major delays in acute care for patients presenting to emergency departments and a general all-pervading view that there will be a significant tightening of belts in anticipation of further financial famine (alliteration at its best?) despite an apparent upturn in our economy in 2014. Read more →
"May your choices reflect your hopes, not your fears."
— Nelson Mandela
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Disclaimer: Any opinion, conclusion or recommendation published by the Links is the sole expression of the writer(s) and does not necessarily reflect the views of the ISHLT.