Levy Phillip D, Bellou Abdel
Associate Professor of Emergency Medicine, Assistant Director of Clinical Research, Cardiovascular Research Institute, Associate Director of Clinical Research, Department of Emergency Medicine, Wayne State University School of Medicine, 4201 St. Antoine; UHC - 6G, Detroit, MI 48201, Office: +1 313 993 8558.
Curr Emerg Hosp Med Rep. 2013 Jun 1;1(2). doi: 10.1007/s40138-013-0012-8.
Dyspnea is the predominant symptom for patients with acute heart failure and initial treatment is largely directed towards the alleviation of this. Contrary to conventional belief, not all patients present with fluid overload and the approach to management is rapidly evolving from a solitary focus on diuresis to one that more accurately reflects the complex interplay of underlying cardiac dysfunction and acute precipitant. Effective treatment thus requires an understanding of divergent patient profiles and an appreciation of various therapeutic options for targeted patient stabilization. The key principle within this paradigm is directed management that aims to diminish the work of breathing through situation appropriate ventillatory support, volume reduction and hemodynamic improvement. With such an approach, clinicians can more efficiently address respiratory discomfort while reducing the likelihood of avoidable harm.
呼吸困难是急性心力衰竭患者的主要症状,初始治疗主要针对缓解这一症状。与传统观念相反,并非所有患者都存在液体超负荷,管理方法正迅速从单纯关注利尿转变为更准确地反映潜在心脏功能障碍和急性诱因的复杂相互作用。因此,有效的治疗需要了解不同的患者情况,并认识到针对患者稳定的各种治疗选择。这一范式的关键原则是针对性管理,旨在通过适当的通气支持、减少容量和改善血流动力学来减轻呼吸负担。通过这种方法,临床医生可以更有效地解决呼吸不适,同时降低可避免伤害的可能性。