scholarly journals A narrative review on the management of Acute Heart Failure in Emergency Medicine Department

2020 ◽  
Vol 30 (1) ◽  
pp. 171-178
Author(s):  
Amin Saberinia ◽  
Ali Vafaei ◽  
Parvin Kashani

The main urgent symptom presented to anemergency departmentis acute heart failure (AHF). In that considerable risksof morbidity and mortality, it isimportant to plan precision medicine to achieve the most suitable outcomes. The object of this review is to provide a summary of contemporary management proceduresof emergency medicine in a department of acute heart failure. Heart failure could be presented with a broad range of symptoms, in particular a sudden worsening of those of Chronic Obstructive Pulmonary Disease. The treatment should focus on acute and chronic underlying disorders with instructions focusing on haemodynamics and blood pressure status. Treatment of patients suffering with worsening symptoms of AHF mainly focuses on intravenous diuretics. In emergency situations, patients suffering with AHF with low blood pressure must receive emergency consultation and a primary fluid bolus therapy (range 250–500 mL) followed by inotropic therapy with or without antihypotensive agents. For treatment of severe heart failure and cardiogenic shock in patients treated with noradrenalin, when blood pressure support is required, a direct-acting inotropic agent, dobutamine, could be applied effectively. When non-invasive positive pressure ventilation is needed, suppliers must track for any possibility of sudden worsening, i.e., for acute de compensated heart failure. When cardiac output is high the disorder could be treated with vasopressor.

2007 ◽  
pp. 527-533
Author(s):  
P Skyba ◽  
P Joppa ◽  
M Orolín ◽  
R Tkáčová

Sympathetic activation and parasympathetic withdrawal are commonly observed during acute exacerbations of chronic obstructive pulmonary disease (COPD). We have demonstrated previously that noninvasive positive-pressure ventilation (NPPV) improves parasympathetic neural control of heart rate in patients with obstructive sleep apnea. We hypothesized that NPPV may exert such beneficial effects in COPD as well. Therefore, we assessed the acute effects of NPPV on systemic blood pressure and indexes of heart rate variability (HRV) in 23 patients with acute exacerbations of COPD. The measurements of HRV in the frequency domain were computed by an autoregressive spectral technique. The use of NPPV resulted in significant increases of oxygen saturation (from 89.2+/-1.0 to 92.4+/-0.9 %, p<0.001) in association with reductions in systolic and diastolic blood pressures and heart rate (from 147+/-3 to 138+/-3 mm Hg, from 86+/-2 to 81+/-2 mm Hg, from 85+/-3 to 75+/-2 bpm, p<0.001 for all variables), and increases in ln-transformed high frequency band of HRV (from 6.4+/-0.5 to 7.4+/-0.6 ms(2)/Hz, p<0.01). Reductions in heart rate and increases in ln-transformed HF band persisted after NPPV withdrawal. In conclusion, these findings suggest that NPPV may cause improvements in the neural control of heart rate in patients with acute exacerbations of COPD.


2018 ◽  
Vol 13 (3) ◽  
pp. 351-357 ◽  
Author(s):  
Karine Luz Londoño ◽  
Francesc Formiga ◽  
David Chivite ◽  
Rafael Moreno-Gonzalez ◽  
Margherita Migone De Amicis ◽  
...  

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