Document Detail


Assessing and grading congestion in acute heart failure: a scientific statement from the acute heart failure committee of the heart failure association of the European Society of Cardiology and endorsed by the European Society of Intensive Care Medicine.
MedLine Citation:
PMID:  20354029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with acute heart failure (AHF) require urgent in-hospital treatment for relief of symptoms. The main reason for hospitalization is congestion, rather than low cardiac output. Although congestion is associated with a poor prognosis, many patients are discharged with persistent signs and symptoms of congestion and/or a high left ventricular filling pressure. Available data suggest that a pre-discharge clinical assessment of congestion is often not performed, and even when it is performed, it is not done systematically because no method to assess congestion prior to discharge has been validated. Grading congestion would be helpful for initiating and following response to therapy. We have reviewed a variety of strategies to assess congestion which should be considered in the care of patients admitted with HF. We propose a combination of available measurements of congestion. Key elements in the measurement of congestion include bedside assessment, laboratory analysis, and dynamic manoeuvres. These strategies expand by suggesting a routine assessment of congestion and a pre-discharge scoring system. A point system is used to quantify the degree of congestion. This score offers a new instrument to direct both current and investigational therapies designed to optimize volume status during and after hospitalization. In conclusion, this document reviews the available methods of evaluating congestion, provides suggestions on how to properly perform these measurements, and proposes a method to quantify the amount of congestion present.
Authors:
Mihai Gheorghiade; Ferenc Follath; Piotr Ponikowski; Jeffrey H Barsuk; John E A Blair; John G Cleland; Kenneth Dickstein; Mark H Drazner; Gregg C Fonarow; Tiny Jaarsma; Guillaume Jondeau; Jose Lopez Sendon; Alexander Mebazaa; Marco Metra; Markku Nieminen; Peter S Pang; Petar Seferovic; Lynne W Stevenson; Dirk J van Veldhuisen; Faiez Zannad; Stefan D Anker; Andrew Rhodes; John J V McMurray; Gerasimos Filippatos; ;
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Publication Detail:
Type:  Journal Article; Practice Guideline; Review     Date:  2010-03-30
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2011-06-02     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  423-33     Citation Subset:  IM    
Affiliation:
Center for Cardiovascular Quality and Outcomes, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Cardiology / trends*
Dizziness
Dyspnea
Edema, Cardiac
Europe
Health Status Indicators
Heart Failure / classification,  diagnosis,  drug therapy*,  physiopathology
Humans
Intensive Care / trends*
Physical Exertion
Prognosis
Respiratory Sounds
Risk Assessment
Societies, Medical*
Comments/Corrections
Comment In:
Eur J Heart Fail. 2010 Oct;12(10):1140   [PMID:  20801930 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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