Practical recommendations for prehospital and early in-hospital management of patients presenting with acute heart failure syndromes

Alexandre Mebazaa*, Mihai Gheorghiade, Ileana L. Piña, Veli Pekka Harjola, Steven M. Hollenberg, Ferenc Follath, Andrew Rhodes, Patrick Plaisance, Edmond Roland, Markku Nieminen, Michel Komajda, Alexander Parkhomenko, Josep Masip, Faiez Zannad, Gerasimos Filippatos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

176 Scopus citations

Abstract

Guideline recommendations for the prehospital and early in-hospital (first 6-12 hrs after presentation) management of acute heart failure syndromes are lacking. The American College of Cardiology/American Heart Association and European Society of Cardiology guidelines direct the management of these acute heart failure patients, but specific consensus on early management has not been published, primarily because few early management trials have been conducted. This article summarizes practical recommendations for the prehospital and early management of patients with acute heart failure syndromes; the recommendations were developed from a meeting of experts in cardiology, emergency medicine, and intensive care medicine from Europe and the United States. The recommendations are based on a unique clinical classification system considering the initial systolic blood pressure and other symptoms: 1) dyspnea and/or congestion with systolic blood pressure >140 mm Hg; 2) dyspnea and/or congestion with systolic blood pressure 100-140 mm Hg; 3) dyspnea and/or congestion with systolic blood pressure <100 mm Hg; 4) dyspnea and/or congestion with signs of acute coronary syndrome; and 5) isolated right ventricular failure. These practical recommendations are not intended to replace existing guidelines. Rather, they are meant to serve as a tool to facilitate guideline implementation where data are available and to provide suggested treatment approaches where formal guidelines and definitive evidence are lacking.

Original languageEnglish (US)
Pages (from-to)S129-S139
JournalCritical care medicine
Volume36
Issue number1 SUPPL.
DOIs
StatePublished - Jan 2008

Keywords

  • Acute
  • Emergency treatment
  • Heart failure

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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