急性失代偿性心力衰竭入院患者的管理
Management of Patients Admitted with Acute Decompensated Heart Failure.
作者信息
Krim Selim R, Campbell Patrick T, Desai Sapna, Mandras Stacy, Patel Hamang, Eiswirth Clement, Ventura Hector O
机构信息
Section of Cardiomyopathy and Heart Transplantation, John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Section of Cardiomyopathy and Heart Transplantation, John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA.
出版信息
Ochsner J. 2015 Fall;15(3):284-9.
BACKGROUND
Hospital admission for the treatment of acute decompensated heart failure is an unfortunate certainty in the vast majority of patients with heart failure. Regardless of the etiology, inpatient treatment for acute decompensated heart failure portends a worsening prognosis.
METHODS
This review identifies patients with heart failure who need inpatient therapy and provides an overview of recommended therapies and management of these patients in the hospital setting.
RESULTS
Inpatient therapy for patients with acute decompensated heart failure should be directed at decongestion and symptom improvement. Clinicians should also treat possible precipitating events, identify comorbid conditions that may exacerbate heart failure, evaluate and update current guideline-directed medical therapy, and perform risk stratification for all patients. Finally, efforts should be made to educate patients about the importance of restricting salt and fluid, monitoring daily weights, and adhering to a graded exercise program.
CONCLUSION
Early discharge follow-up and continued optimization of guideline-directed medical therapy are key to preventing future heart failure readmissions.
背景
对于绝大多数心力衰竭患者而言，因急性失代偿性心力衰竭而住院治疗是难以避免的。无论病因如何，急性失代偿性心力衰竭的住院治疗都预示着预后会恶化。
方法
本综述确定了需要住院治疗的心力衰竭患者，并概述了在医院环境中对这些患者推荐的治疗方法和管理措施。
结果
急性失代偿性心力衰竭患者的住院治疗应旨在减轻充血和改善症状。临床医生还应治疗可能的诱发事件，识别可能加重心力衰竭的合并症，评估并更新当前的指南指导药物治疗，并对所有患者进行风险分层。最后，应努力教育患者限制盐和液体摄入、监测每日体重以及坚持分级运动计划的重要性。
结论
早期出院随访和持续优化指南指导的药物治疗是预防未来心力衰竭再入院的关键。
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