Fermann Gregory J, Collins Sean P
Department of Emergency Medicine, University of Cincinnati, PO Box 670769, Cincinnati, OH 45267, USA.
Curr Heart Fail Rep. 2010 Sep;7(3):125-33. doi: 10.1007/s11897-010-0020-x.
Observation units (OUs) for acute heart failure syndromes (AHFS) have proven to be effective in reducing heart failure admissions and may reduce costs. Goals for risk-stratifying patients with AHFS in OUs include determining patients suitable for OU management and determining end points of treatment. Although many provider models and settings exist, management algorithms common to most OUs include monitoring/nursing care, diagnostic procedures, therapy, and educational/social services. The focus of OU management involves an assessment of the factors that led to the decompensation and identification of the predominant clinical features such as hypertension and congestion. Acute therapy still leans heavily on symptom relief with diuretics and nitroglycerin. For newly diagnosed patients, initiation of guideline-recommended therapies like angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and beta-blockers is an integral part of OU protocols. Patient education and coordination of outpatient care continues to be paramount in preventing early readmission in this patient population.
事实证明，急性心力衰竭综合征（AHFS）的观察单元（OU）在减少心力衰竭住院人数方面有效，并且可能降低成本。对AHFS患者在观察单元进行风险分层的目标包括确定适合观察单元管理的患者以及确定治疗终点。尽管存在多种医疗服务模式和环境，但大多数观察单元通用的管理算法包括监测/护理、诊断程序、治疗以及教育/社会服务。观察单元管理的重点在于评估导致失代偿的因素，并识别诸如高血压和充血等主要临床特征。急性治疗仍然严重依赖利尿剂和硝酸甘油来缓解症状。对于新诊断的患者，启动如血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂以及β受体阻滞剂等指南推荐的治疗方法是观察单元方案的一个组成部分。在预防该患者群体早期再入院方面，患者教育和门诊护理协调仍然至关重要。
