CFM Cardiology Practice Test

When a VAD is set to a high pump speed, the device can pull on the ventricle more than it can fill, creating suction and unstable flow. The best first move is gentle fluid resuscitation to boost preload and improve LVAD filling, which often resolves suction by restoring enough blood to meet the pump’s demand. This approach directly addresses inadequate volume status that can accompany high-speed settings. If preload is now adequate but suction or instability persists, you would then consider adjusting the pump speed downward. Other options, such as increasing vasopressors or giving diuretics, tend to worsen preload or volume status and are not the initial step. Ramping down the speed immediately without assessing preload may be necessary later, but the starting step is to improve volume status with careful fluid administration.