Smith Andrew Lee, Brown Carolyn S
Center for Heart Failure Therapy, Emory University Hospital, Atlanta, Ga., USA.
Crit Care Nurse. 2003 Feb;Suppl:11-8; quiz 19-20.
As briefly summarized in this report, the prevalence of heart failure is high and it will continue to rise as the population ages. There will be over 1 million hospitalizations for acutely decompensated heart failure this year. The goals of treatment for patients with acutely decompensated heart failure are to lower cardiac filling pressures, remove fluids and improve symptoms of dyspnea, decrease vascular resistance, and increase cardiac output without activating the RAAS. There are few guidelines for the treatment of individuals with acutely decompensated heart failure and many different agents have been used in patients with this disease. Many of these drugs are not completely effective and may lead to serious adverse events. BNP is a natural protein produced by myocardial cells in response to ventricular distension, and its level is dramatically increased in patients with heart failure. The results of several recent clinical trials have shown that administration of nesiritide is safe and highly effective for the initial treatment of patients with acutely decompensated heart failure and can help physicians and nurses meet treatment goals for the management of patients with this serious condition.
如本报告简要总结的那样,心力衰竭的患病率很高,并且随着人口老龄化还将继续上升。今年急性失代偿性心力衰竭的住院人数将超过100万。急性失代偿性心力衰竭患者的治疗目标是降低心脏充盈压、排出液体并改善呼吸困难症状、降低血管阻力以及在不激活肾素 - 血管紧张素 - 醛固酮系统(RAAS)的情况下增加心输出量。对于急性失代偿性心力衰竭患者的治疗几乎没有指南,并且在患有这种疾病的患者中使用了许多不同的药物。这些药物中的许多并不完全有效,并且可能导致严重的不良事件。脑钠肽(BNP)是心肌细胞响应心室扩张而产生的一种天然蛋白质,其水平在心力衰竭患者中显著升高。最近几项临床试验的结果表明,给予奈西立肽对于急性失代偿性心力衰竭患者的初始治疗是安全且高效的,并且可以帮助医生和护士实现对这种严重疾病患者的治疗目标。