Preoperative Nutritional Optimization and Physical Exercise for Patients Scheduled for Elective Implantation for a Left-Ventricular Assist Device—The PROPER-LVAD Study
, Vera von Dossow 3, Daren K. Heyland 4, Rolf Rossaint 1, Patrick Meybohm 5, Henrik Fox 6, Michiel Morshuis 6, Gunnar Elke 7, Bernd Panholzer 8, Assad Haneya 8, Andreas Böning 9, Bernd Niemann 9, Rashad Zayat 10, Ajay Moza 10 and Christian Stoppe 5,11,*
Marzia Cottini
Round 1
Reviewer 1 Report
The manuscript is interesting, well organised and well presented. The LVAD and its management is a daily challenge and your manuscript could improve the quality of it.
I think you could insert more data of LVAD type and basic pathology but it is my opinion, in that way the manuscript has already acceptable
Author Response
We kindly thank the reviewer for the positive feedback! We have added a few details (lines 65-74) but wanted to avoid a lengthy manuscript.
"…time of 48 months [10].
However, all major surgical procedures are associated with a systemic inflammatory response syndrome (SIRS). While SIRS is anticipated after cardiac surgery and LVAD implantation, this syndrome can cause multiple acute and persistent organ dysfunctions, perioperative complications, longer hospital stay and delayed rehabilitation [11-15]. Postoperative complications are a major determinant of morbidity, mortality, length-of-hospital-stay, hospital costs and quality of live after heart surgery [16].
With an increasingly comorbid and…"
Reviewer 2 Report
This protocol paper is well written. The protocol is considered feasible, and patient safety and ethical considerations are well addressed. Prehabilitation in patients with severe heart failure scheduled for left ventricular assist device (LVAD) implantation is of increasing interest. Therefore, this article is of great clinical relevance. I consider this protocol paper acceptable for publication after minor revision.
Minor comment
There is a small error in Line 152 that appears to be technical and should be corrected.
Author Response
We appreciate the reviewer´s positive feedback! We have corrected the mistake in line 152:
48 adult patients who are scheduled for the elective implantation of an LVAD are screened and enrolled consecutively. Written informed consent is obtained from all patients after receiving written information and having the study procedures explained and questions answered in a face-to face visit with a medical doctor with due time to consider. Eligibility criteria are listed in Table 3.
