Acute heart failure and cardiogenic shock: a multidisciplinary
practical guidance

J 2016

Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance

MEBAZAA, A., H. TOLPPANEN, C. MUELLER, J. LASSUS, S. DISOMMA et. al.

Basic information

Original name

Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance

Authors

MEBAZAA, A. (250 France), H. TOLPPANEN (246 Finland), C. MUELLER (756 Switzerland), J. LASSUS (246 Finland), S. DISOMMA (380 Italy), G. BAKSYTE (440 Lithuania), M. CECCONI (826 United Kingdom of Great Britain and Northern Ireland), D.J. CHOI (410 Republic of Korea), A.C. SOLAL (250 France), M. CHRIST (276 Germany), J. MASIP (724 Spain), M. ARRIGO (250 France), S. NOUIRA (788 Tunisia), D. OJJI (566 Nigeria), F. PEACOCK (840 United States of America), M. RICHARDS (554 New Zealand), N. SATO (392 Japan), K. SLIWA (710 South Africa), Jindřich ŠPINAR (203 Czech Republic, guarantor, belonging to the institution), H. THIELE (276 Germany), M.B. YILMAZ (792 Turkey) and J. JANUZZI (840 United States of America)

Edition

Intensive care medicine, NEW YORK, SPRINGER, 2016, 0342-4642

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 12.015

RIV identification code

RIV/00216224:14110/16:00090652

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s00134-015-4041-5

UT WoS

000368722000002

Keywords in English

Heart failure; Cardiogenic shock; Emergency; Treatment

Abstract

V originále

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.

Citovat

MEBAZAA, A., H. TOLPPANEN, C. MUELLER, J. LASSUS, S. DISOMMA, G. BAKSYTE, M. CECCONI, D.J. CHOI, A.C. SOLAL, M. CHRIST, J. MASIP, M. ARRIGO, S. NOUIRA, D. OJJI, F. PEACOCK, M. RICHARDS, N. SATO, K. SLIWA, Jindřich ŠPINAR, H. THIELE, M.B. YILMAZ and J. JANUZZI. Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance. Intensive care medicine. NEW YORK: SPRINGER, 2016, vol. 42, No 2, p. 147-163. ISSN 0342-4642. Available from: https://dx.doi.org/10.1007/s00134-015-4041-5.

@article{1352670,
   author = {Mebazaa, A. and Tolppanen, H. and Mueller, C. and Lassus, J. and DiSomma, S. and Baksyte, G. and Cecconi, M. and Choi, D.J. and Solal, A.C. and Christ, M. and Masip, J. and Arrigo, M. and Nouira, S. and Ojji, D. and Peacock, F. and Richards, M. and Sato, N. and Sliwa, K. and Špinar, Jindřich and Thiele, H. and Yilmaz, M.B. and Januzzi, J.},
   article_location = {NEW YORK},
   article_number = {2},
   doi = {http://dx.doi.org/10.1007/s00134-015-4041-5},
   keywords = {Heart failure; Cardiogenic shock; Emergency; Treatment},
   language = {eng},
   issn = {0342-4642},
   journal = {Intensive care medicine},
   title = {Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance},
   volume = {42},
   year = {2016}
}

TY  - JOUR
ID  - 1352670
AU  - Mebazaa, A. - Tolppanen, H. - Mueller, C. - Lassus, J. - DiSomma, S. - Baksyte, G. - Cecconi, M. - Choi, D.J. - Solal, A.C. - Christ, M. - Masip, J. - Arrigo, M. - Nouira, S. - Ojji, D. - Peacock, F. - Richards, M. - Sato, N. - Sliwa, K. - Špinar, Jindřich - Thiele, H. - Yilmaz, M.B. - Januzzi, J.
PY  - 2016
TI  - Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance
JF  - Intensive care medicine
VL  - 42
IS  - 2
SP  - 147-163
EP  - 147-163
PB  - SPRINGER
SN  - 03424642
KW  - Heart failure
KW  - Cardiogenic shock
KW  - Emergency
KW  - Treatment
N2  - 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.
ER  -

MEBAZAA, A., H. TOLPPANEN, C. MUELLER, J. LASSUS, S. DISOMMA, G. BAKSYTE, M. CECCONI, D.J. CHOI, A.C. SOLAL, M. CHRIST, J. MASIP, M. ARRIGO, S. NOUIRA, D. OJJI, F. PEACOCK, M. RICHARDS, N. SATO, K. SLIWA, Jindřich ŠPINAR, H. THIELE, M.B. YILMAZ and J. JANUZZI. Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance. \textit{Intensive care medicine}. NEW YORK: SPRINGER, 2016, vol.~42, No~2, p.~147-163. ISSN~0342-4642. Available from: https://dx.doi.org/10.1007/s00134-015-4041-5.

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