Management Strategies to Meet the Core Heart Failure Measures for Acute Decompensated Heart Failure

2007 ◽  
Vol 30 (4) ◽  
pp. 307-320 ◽  
Author(s):  
Nancy J. Gardetto ◽  
Karen C. Carroll
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Management Strategies ◽  
Decompensated Heart Failure ◽  
The Core

Cardiac Arrhythmias, Acute Coronary Syndromes, and Heart Failure in the Surgical Patient

2018 ◽  
Author(s):  
Glen Franklin ◽  
Amirreza Motameni ◽  
Johnson Walker
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Cardiac Arrhythmias ◽  
Acute Coronary Syndromes ◽  
Acute Decompensated Heart Failure ◽  
Management Strategies ◽  
Decompensated Heart Failure ◽  
Surgical Patient ◽  
Coronary Syndrome ◽  
Coronary Syndromes

Cardiac arrhythmias and events, such as acute coronary syndrome and acute decompensated heart failure, are becoming increasingly common with an aging population. Much is written regarding the evaluation and management of these conditions in the cardiac and vascular patient populations; however, there is less literature to discuss the management strategies in the critically ill noncardiac postoperative and polytrauma patients. Factors such as physiologic stress, electrolyte imbalances, neurologic derangement, infection, and massive fluid shifts create an environment that promotes cardiopulmonary instability. Appropriate recognition of cardiac arrhythmias, acute coronary syndromes, and heart failure coupled with accurate and timely intervention can reduce morbidity and mortality in these patients. This review discusses the assessment and management of cardiac tachy- and brady-arrhythmias, acute coronary syndromes, and acute decompensated heart failure in the surgical patient. This review contains 4 figures, 5 tables and 45 references Key Words: acute coronary syndrome, angina, arrhythmia, bradycardia, cardiac ischemia, dieresis, fluid overload, heart failure, infarction, tachycardia

Cardiac Arrhythmias, Acute Coronary Syndromes, and Heart Failure in the Surgical Patient

2018 ◽  
Author(s):  
Glen Franklin ◽  
Amirreza Motameni ◽  
Johnson Walker
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Cardiac Arrhythmias ◽  
Acute Coronary Syndromes ◽  
Acute Decompensated Heart Failure ◽  
Management Strategies ◽  
Decompensated Heart Failure ◽  
Surgical Patient ◽  
Coronary Syndrome ◽  
Coronary Syndromes

Cardiac arrhythmias and events, such as acute coronary syndrome and acute decompensated heart failure, are becoming increasingly common with an aging population. Much is written regarding the evaluation and management of these conditions in the cardiac and vascular patient populations; however, there is less literature to discuss the management strategies in the critically ill noncardiac postoperative and polytrauma patients. Factors such as physiologic stress, electrolyte imbalances, neurologic derangement, infection, and massive fluid shifts create an environment that promotes cardiopulmonary instability. Appropriate recognition of cardiac arrhythmias, acute coronary syndromes, and heart failure coupled with accurate and timely intervention can reduce morbidity and mortality in these patients. This review discusses the assessment and management of cardiac tachy- and brady-arrhythmias, acute coronary syndromes, and acute decompensated heart failure in the surgical patient. This review contains 4 figures, 5 tables and 45 references Key Words: acute coronary syndrome, angina, arrhythmia, bradycardia, cardiac ischemia, dieresis, fluid overload, heart failure, infarction, tachycardia

Fluid Management Strategies in Heart Failure

2012 ◽  
Vol 32 (2) ◽  
pp. 20-32 ◽  
Author(s):  
Nancy M. Albert
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Fluid Management ◽  
Management Strategies ◽  
Signs And Symptoms ◽  
Decompensated Heart Failure ◽  
Performance Measure ◽  
Fluid Retention ◽  
Cardiac Device ◽  
Nurse Administrators

In patients with chronic heart failure, fluid retention (or hypervolemia) is often the stimulus for acute decompensated heart failure that requires hospitalization. The pathophysiology of fluid retention is complex and involves both hemodynamic and clinical congestion. Signs and symptoms of both hemodynamic and clinical congestion should be assessed serially during hospitalization. Core heart failure drug and cardiac device therapies should be provided, and ultrafiltration may be warranted. Critical care, intermediate care, and telemetry nurses have roles in both assessment and management of patients hospitalized with acute decompensated heart failure and fluid retention. Nurse administrators and managers have heightened their attention to fluid retention because the Medicare performance measure known as the risk-standardized 30-day all-cause readmission rate after heart failure hospitalization can be attenuated by fluid management strategies initiated by nurses during a patient’s hospitalization.

Cardiac Arrhythmias, Acute Coronary Syndromes, and Heart Failure in the Surgical Patient

2018 ◽  
Author(s):  
Glen Franklin ◽  
Amirreza Motameni ◽  
Johnson Walker
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Cardiac Arrhythmias ◽  
Acute Coronary Syndromes ◽  
Acute Decompensated Heart Failure ◽  
Management Strategies ◽  
Decompensated Heart Failure ◽  
Surgical Patient ◽  
Coronary Syndrome ◽  
Coronary Syndromes

Cardiac arrhythmias and events, such as acute coronary syndrome and acute decompensated heart failure, are becoming increasingly common with an aging population. Much is written regarding the evaluation and management of these conditions in the cardiac and vascular patient populations; however, there is less literature to discuss the management strategies in the critically ill noncardiac postoperative and polytrauma patients. Factors such as physiologic stress, electrolyte imbalances, neurologic derangement, infection, and massive fluid shifts create an environment that promotes cardiopulmonary instability. Appropriate recognition of cardiac arrhythmias, acute coronary syndromes, and heart failure coupled with accurate and timely intervention can reduce morbidity and mortality in these patients. This review discusses the assessment and management of cardiac tachy- and brady-arrhythmias, acute coronary syndromes, and acute decompensated heart failure in the surgical patient. This review contains 4 figures, 5 tables and 45 references Key Words: acute coronary syndrome, angina, arrhythmia, bradycardia, cardiac ischemia, dieresis, fluid overload, heart failure, infarction, tachycardia

scholarly journals Comparative pharmacoeconomic analysis of medication for patients after acute decompensated heart failure

2020 ◽  
Vol 25 (1) ◽  
pp. 65-71
Author(s):  
S. K. Zyryanov ◽  
E. A. Ushkalova
Keyword(s):  
Heart Failure ◽  
Impact Analysis ◽  
Acute Decompensated Heart Failure ◽  
Pharmacoeconomic Analysis ◽  
Medication Management ◽  
Management Strategies ◽  
Cost Effective ◽  
Decompensated Heart Failure ◽  
Patients With Heart Failure ◽  
The Cost

Aim. Pharmacoeconomic comparison of medication management strategies (valsartan+ sacubitril) for patients with heart failure (HF), stabilized after an episode of acute decompensated heart failure (ADHF).Material and methods. “Cost — effectiveness analysis” and “Budget impact analysis” were used. The study is conducted in terms of the interests of Russian Federation health care system and budgets of individual regions.Results. The use of valsartan+sacubitril combination will require an increase in direct medical costs for 1 year by 38,5% compared with enalapril. The cost of one life year gained when using the valsartan+sacubitril combination was 307,294 rubles. When estimating data for the target ADHF population (n=200,769), valsartan+sacubitril will require additional 4,4 billion rubles per year. At the same time, this will save almost 17 thousand lives and prevent 126 thousand ambulance calls and 33,9 thousand rehospitalizations, including more than 6,5 thousand in the intensive care unit.Conclusion. The use of valsartan+sacubitril combination in HF patients hospitalized with ADHF is cost-effective management strategy that significantly improves the prognosis in this category of patients.

Assessing Acute Decompensated Heart Failure – Strategies and Tools

2012 ◽  
Vol 8 (2) ◽  
pp. 128
Author(s):  
Ali Vazir ◽  
Martin R Cowie ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Pulse Contour Analysis ◽  
Decompensated Heart Failure ◽  
Rapid Onset ◽  
Clinical Syndrome ◽  
Response To Therapy ◽  
Contour Analysis ◽  
Physiological Variables ◽  
Co Morbidity

Acute heart failure – the rapid onset of, or change in, signs and/or symptoms of heart failure requiring urgent treatment – is a serious clinical syndrome, associated with high mortality and healthcare costs. History, physical examination and early 2D and Doppler echocardiography are crucial to the proper assessment of patients, and will help determine the appropriate monitoring and management strategy. Most patients are elderly and have considerable co-morbidity. Clinical assessment is key to monitoring progress, but a number of clinical techniques – including simple Doppler and echocardiographic tools, pulse contour analysis and impedance cardiography – can help assess the response to therapy. A pulmonary artery catheter is not a routine monitoring tool, but can be very useful in patients with complex physiology, in those who fail to respond to therapy as would be anticipated, or in those being considered for mechanical intervention. As yet, the serial measurement of plasma natriuretic peptides is of limited value, but it does have a role in diagnosis and prognostication. Increasingly, the remote monitoring of physiological variables by completely implanted devices is possible, but the place of such technology in clinical practice is yet to be clearly established.

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