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Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance.
Mebazaa, A; Tolppanen, H; Mueller, C; Lassus, J; DiSomma, S; Baksyte, G; Cecconi, M; Choi, D J; Cohen Solal, A; Christ, M; Masip, J; Arrigo, M; Nouira, S; Ojji, D; Peacock, F; Richards, M; Sato, N; Sliwa, K; Spinar, J; Thiele, H; Yilmaz, M B; Januzzi, J.
Afiliación
  • Mebazaa A; U 942 Inserm, Paris, France. alexandre.mebazaa@aphp.fr.
  • Tolppanen H; University Paris Diderot, Sorbonne Paris Cité, Paris, France. alexandre.mebazaa@aphp.fr.
  • Mueller C; Department of Anesthesia and Critical Care, Hôpital Lariboisière, APHP, Paris, France. alexandre.mebazaa@aphp.fr.
  • Lassus J; U 942 Inserm, Paris, France.
  • DiSomma S; Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland.
  • Baksyte G; Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland.
  • Cecconi M; Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland.
  • Choi DJ; Department of Medical Sciences and Translational Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.
  • Cohen Solal A; Department of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
  • Christ M; Anaesthesia and Intensive Care, St George's Hospital and Medical School, London, SW17 0QT, UK.
  • Masip J; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Arrigo M; U 942 Inserm, Paris, France.
  • Nouira S; University Paris Diderot, Sorbonne Paris Cité, Paris, France.
  • Ojji D; Department of Cardiology, Hôpital Lariboisiere, APHP, Paris, France.
  • Peacock F; Department of Emergency and Intensive Care Medicine, Paracelsus Medical University, Nuremberg, Germany.
  • Richards M; Department of Intensive Care Medicine, Consorci Sanitari Integral, University of Barcelona, Barcelona, Spain.
  • Sato N; U 942 Inserm, Paris, France.
  • Sliwa K; Emergency Department and Research Unit UR06SP21, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
  • Spinar J; Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.
  • Thiele H; Department of Emergency Medicine, Baylor College of Medicine, Boston, MA, USA.
  • Yilmaz MB; Christchurch Cardioendocrine Research Group, Christchurch Hospital, Christchurch, New Zealand.
  • Januzzi J; Internal Medicine, Cardiology, and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kawasaki, Japan.
Intensive Care Med ; 42(2): 147-63, 2016 Feb.
Article en En | MEDLINE | ID: mdl-26370690
PURPOSE: Acute heart failure (AHF) causes high burden of mortality, morbidity, and repeated hospitalizations worldwide. This guidance paper describes the tailored treatment approaches of different clinical scenarios of AHF and CS, focusing on the needs of professionals working in intensive care settings. RESULTS: Tissue congestion and hypoperfusion are the two leading mechanisms of end-organ injury and dysfunction, which are associated with worse outcome in AHF. Diagnosis of AHF is based on clinical assessment, measurement of natriuretic peptides, and imaging modalities. Simultaneously, emphasis should be given in rapidly identifying the underlying trigger of AHF and assessing severity of AHF, as well as in recognizing end-organ injuries. Early initiation of effective treatment is associated with superior outcomes. Oxygen, diuretics, and vasodilators are the key therapies for the initial treatment of AHF. In case of respiratory distress, non-invasive ventilation with pressure support should be promptly started. In patients with severe forms of AHF with cardiogenic shock (CS), inotropes are recommended to achieve hemodynamic stability and restore tissue perfusion. In refractory CS, when hemodynamic stabilization is not achieved, the use of mechanical support with assist devices should be considered early, before the development of irreversible end-organ injuries. CONCLUSION: A multidisciplinary approach along the entire patient journey from pre-hospital care to hospital discharge is needed to ensure early recognition, risk stratification, and the benefit of available therapies. Medical management should be planned according to the underlying mechanisms of various clinical scenarios of AHF.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Cardiogénico / Enfermedad Aguda / Guías de Práctica Clínica como Asunto / Cuidados Críticos / Insuficiencia Cardíaca Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: Intensive Care Med Año: 2016 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Cardiogénico / Enfermedad Aguda / Guías de Práctica Clínica como Asunto / Cuidados Críticos / Insuficiencia Cardíaca Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: Intensive Care Med Año: 2016 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos