Related Experiment Video
Updated: Oct 12, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Non-patient factors associated with infections in LVAD recipients: A scoping review
Supriya Shore1, Michael J Pienta2, Tessa M F Watt2
1Division of Cardiovascular Medicine.
Background:
Infections are the most common complication in recipients of durable left ventricular assist devices (LVAD) and are associated with increased morbidity, mortality, and expenditures. The existing literature examining factors associated with infection in LVAD recipients is limited and principally comprises single-center studies. This scoping review synthesizes all available evidence related to identifying modifiable, non-patient factors associated with infections among LVAD recipients.
Methods:
Published studies were identified through searching 5 bibliographic databases: PubMed, Scopus, EMBASE, CINAHL, and Web of Science Core Collection. Inclusion criteria required examination of factors associated with infections among recipients of contemporary, implantable, continuous flow LVADs. Key study characteristics were extracted by 4 independent reviewers and current literature described narratively. The Systems Engineering Initiative for Patient Safety (SEIPS) model was used to develop a taxonomy for non-patient related factors (e.g., tasks, tools, technologies, organization, and environment) associated with infections following LVAD implantation. All analyses took place between February 2019 and May 2021.
Findings:
A total of 43 studies met inclusion criteria. The majority of included studies were observational (n = 37), single-center (n = 29), from the U.S. (n = 38), and focused on driveline infections (n = 40). Among the 22 evaluated sub-domains of non-patient related factors, only two: increasing center experience and establishing a silicone-skin interface at the driveline exit site, were identified as consistently being associated with a lower risk of infection.
Conclusion:
This review identified 43 studies that described non-patient related factors associated with infection in LVAD recipients. Only two factors were consistently associated with lower infection risk in LVAD recipients: increasing experience and establishing a silicone-skin interface at driveline exit site. The large variability in reporting across multiple studied interventions limited the ability to discern their effectiveness.
Insights
Infections are common in left ventricular assist device (LVAD) recipients. Increasing center experience and a silicone-skin interface at the driveline exit site are key to reducing infection risk.
Area of Science:
- Medical research
- Cardiovascular surgery
- Infectious disease
Background:
- Infections are a frequent complication for patients with durable left ventricular assist devices (LVADs).
- These infections increase patient morbidity, mortality, and healthcare costs.
- Limited research exists on non-patient factors influencing LVAD infections, with most studies being single-center.
Purpose of the Study:
- To conduct a scoping review of existing literature.
- To identify modifiable, non-patient-related factors associated with infections in LVAD recipients.
Main Methods:
- Searched five major bibliographic databases for relevant studies.
- Included studies focusing on contemporary, implantable, continuous flow LVADs.
- Utilized the Systems Engineering Initiative for Patient Safety (SEIPS) model to categorize non-patient factors.
Main Results:
- Analyzed 43 studies, predominantly observational and single-center from the U.S.
- Focused on driveline infections, which were the subject of most studies (n=40).
- Identified only two factors consistently linked to lower infection risk: increased center experience and a silicone-skin interface at the driveline exit site.
Conclusions:
- Two non-patient factors consistently reduce infection risk in LVAD recipients: center experience and driveline site management.
- Significant variability in reporting across interventions hindered effectiveness assessment.
- Further research is needed to standardize reporting and evaluate interventions.
More Related Videos
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:29Endocarditis IV: Nursing Management
01:25Endocarditis I: Introduction
01:27Mitral Stenosis IV: Nursing Management