Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group.

Autor: Collins S; Nashville Veterans Affairs Medical Center and Vanderbilt University, Nashville, Tennessee. Electronic address: sean.collins@vanderbilt.edu., Storrow AB; Vanderbilt University, Nashville, Tennessee., Albert NM; Cleveland Clinic, Cleveland, Ohio., Butler J; Emory University, Atlanta, Georgia., Ezekowitz J; University of Alberta, Edmonton, Alberta, Canada., Felker GM; Duke University, Durham, North Carolina., Fermann GJ; University of Cincinnati, Cincinnati, Ohio., Fonarow GC; Ronald Reagan-UCLA Medical Center, Los Angeles, California., Givertz MM; Harvard Medical School, Boston, Massachusetts., Hiestand B; Wake Forest University, Winston-Salem, North Carolina., Hollander JE; Thomas Jefferson University, Philadelphia, Pennsylvania., Lanfear DE; Henry Ford Hospital, Detroit, Michigan., Levy PD; Wayne State University, Detroit, Michigan., Pang PS; Indiana University School of Medicine, Indianapolis, Indiana., Peacock WF; Baylor College of Medicine, Houston, Texas., Sawyer DB; Vanderbilt University, Nashville, Tennessee., Teerlink JR; San Francisco Veterans Affairs Medical Center, University of California, San Francisco, California., Lenihan DJ; Vanderbilt University, Nashville, Tennessee.
Jazyk: angličtina
Zdroj: Journal of cardiac failure [J Card Fail] 2015 Jan; Vol. 21 (1), pp. 27-43. Date of Electronic Publication: 2014 Jul 18.
DOI: 10.1016/j.cardfail.2014.07.003
Abstrakt: Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition decisions cannot be underestimated. Predictive instruments that identify a cohort of patients safe for ED discharge, while simultaneously addressing barriers to successful outpatient management, have the potential to significantly impact quality of life and resource expenditures.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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