J 2024

Acute heart failure - an EFIM guideline critical appraisal and adaptation for internists

KOKORIN, Valentin A, Alvaro GONZALEZ-FRANCO, Antonio CITTADINI, Oskars KALEJS, Vera N LARINA et. al.

Basic information

Original name

Acute heart failure - an EFIM guideline critical appraisal and adaptation for internists

Authors

KOKORIN, Valentin A, Alvaro GONZALEZ-FRANCO, Antonio CITTADINI, Oskars KALEJS, Vera N LARINA, Alberto M MARRA, Francisco J MEDRANO, Zdeněk MONHART (203 Czech Republic, belonging to the institution), Laura MORBIDONI, Joana PIMENTA and Wiktoria LESNIAK

Edition

European Journal of Internal Medicine, AMSTERDAM, ELSEVIER, 2024, 0953-6205

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 8.000 in 2022

Organization unit

Faculty of Medicine

DOI

UT WoS

001239569700001

Keywords in English

Acute heart failure; Clinical practice guideline; Critical assessment; Internal medicine; Consensus

Tags

Tags

International impact, Reviewed
Změněno: 16/8/2024 08:16, Mgr. Tereza Miškechová

Abstract

V originále

Background: Over the past two decades, several studies have been conducted that have tried to answer questions on management of patients with acute heart failure (AHF) in terms of diagnosis and treatment. Updated international clinical practice guidelines (CPGs) have endorsed the findings of these studies. The aim of this document was to adapt recommendations of existing guidelines to help internists make decisions about specific and complex scenarios related to AHF. Methods: The adaptation procedure was to identify firstly unresolved clinical problems in patients with AHF in accordance with the PICO (Population, Intervention, Comparison and Outcomes) process, then conduct a critical assessment of existing CPGs and choose recommendations that are most applicable to these specific scenarios. Results: Seven PICOs were identified and CPGs were assessed. There is no single test that can help clinicians in discriminating patients with acute dyspnoea, congestion or hypoxaemia. Performing of echocardiography and natriuretic peptide evaluation is recommended, and chest X-ray and lung ultrasound may be considered. Treatment strategies to manage arterial hypotension and low cardiac output include short-term continuous intravenous inotropic support, vasopressors, renal replacement therapy, and temporary mechanical circulatory support. The most updated recommendations on how to treat specific patients with AHF and certain comorbidities and for reducing post-discharge rehospitalization and mortality are provided. Overall, 51 recommendations were endorsed and the rationale for the selection is provided in the main text. Conclusion: Through the use of appropriate tailoring process methodology, this document provides a simple and updated guide for internists dealing with AHF patients.