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2023 年急性心力衰竭患者住院期间基本行为共识更新的执行摘要。

Executive summary of the 2023 update on the consensus regarding basic conduct during hospital admission for patients with acute heart failure.

机构信息

Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.

Servicio de Medicina Interna, Hospital Universitario de Getafe, Getafe, Madrid, Spain.

出版信息

Rev Clin Esp (Barc). 2023 Oct;223(8):499-509. doi: 10.1016/j.rceng.2023.07.008. Epub 2023 Jul 26.

Abstract

Acute heart failure (AHF) is associated with significant morbidity and mortality and it stands as the primary cause of hospitalization for individuals over the age of 65 in Spain. This document outlines the main recommendations as follows: (1) Upon admission, it is crucial to conduct a comprehensive assessment, taking into account the patient's standard treatment and comorbidities, as these factors determine the prognosis of the disease. (2) During the initial hours of hospital care, prioritizing decongestive treatment is essential. It is recommended to adopt an early staged diuretic therapeutic approach based on the patient's response. (3) In order to manage patients in the stable phase, it is advisable to consider initiating and/or adjusting evidence-based drug treatments such as sacubitril/valsartan or angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta blockers, aldosterone antagonists, and SGLT2 inhibitors. (4) Upon hospital discharge, utilizing a checklist is recommended to optimize the patient's management and identify the most efficient options for ensuring continuity of care post-discharge.

摘要

急性心力衰竭(AHF)与较高的发病率和死亡率相关,是导致西班牙 65 岁以上人群住院的主要原因。本文件概述了以下主要建议:(1)入院时,必须进行全面评估,考虑患者的标准治疗和合并症,因为这些因素决定了疾病的预后。(2)在住院初期,优先进行利尿治疗。建议根据患者的反应,采取早期阶段的利尿剂治疗方法。(3)为了管理稳定期患者,可以考虑开始和/或调整基于证据的药物治疗,如沙库巴曲缬沙坦或血管紧张素转换酶抑制剂/血管紧张素 II 受体阻滞剂、β受体阻滞剂、醛固酮拮抗剂和 SGLT2 抑制剂。(4)出院时,建议使用清单来优化患者的管理,并确定出院后确保护理连续性的最有效方法。

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