2018年11月8日 星期四

Management of Heart Failure in ED



Management of Heart Failure in the ED Setting:
An Evidence-Based Review of the Literature

J Emerg Med, 2018 Sep 26.
doi: 10.1016/j.jemermed.2018.08.002

Management of Heart Failure in ED

hemodynamic stabilization and symptom relief
ABC

Mild AHF Exacerbation with Systemic Overload
  • Diuretics (bolus or continuous infusion and high- vs. low-dose)
  • Ultrafiltration for refractory AHF
  • Morphine is not recommended

Hypertensive AHF with Pulmonary Edema
  • NIPPV
  • Nitrates (SL, IV)
  • Diuretics

Hypotensive AHF with Cardiogenic Shock
  • Inotropic agents (norepinephrine ± dobutamine)
  • A small fluid bolus 250–500 mL
  • NIPPV or ETT
  • Mechanical circulatory support: IABP, VAD, V-A ECMO.

High-Output Heart Failure
  • Treat underlying etiology

Disposition
  • 80% admission
  • Observation units

Heart Failure Risk Scores

Af with AHF
  • Cardioversion 
  • Digoxin

1 則留言:

Rohit Singh 提到...

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