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文献詳細

雑誌文献

medicina58巻4号

2021年04月発行

文献概要

増刊号 救急診療 好手と悪手 循環器系

急性心不全—適切に初期評価,迅速に治療開始,タイムリミットは1時間!

著者: 戴哲皓1 水野篤2

所属機関: 1東京大学病院循環器内科 2聖路加国際病院循環器内科

ページ範囲:P.84 - P.89

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こんな対応は悪手
①初期評価がクリニカルシナリオ(CS)にとどまる
②左室駆出率(LVEF)が保たれていたら心不全ではないと考える
③エコーでなんとなくEFしかみない
④酸素化が保持された心不全だからのんびりする
⑤β遮断薬を乱暴に扱う

参考文献

1)Tsutsui H, et al:JCS 2017/JHFS 2017 Guideline on diagnosis and treatment of acute and chronic heart failure - Digest Version -. Circ J 83:2084-2184, 2019
2)Mebazaa A, et al:Practical recommendations for prehospital and early in-hospital management of patients presenting with acute heart failure syndromes. Crit Care Med 36:S129-S139, 2008
3)Stevenson LW:Tailored therapy to hemodynamic goals for advanced heart failure. Eur J Heart Fail 1:251-257, 1999
4)Stevenson LW, Perloff JK:The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. JAMA 261:884-888, 1989
5)Mitchell C, et al:Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults;Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 32:1-64, 2019
6)Firstenberg MS, et al:Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers. J Am Coll Cardiol 36:1664-1669, 2000
7)Mebazaa A, et al:Acute heart failure and cardiogenic shock;A multidisciplinary practical guidance. Intensive Care Med 42:147-163, 2016
8)Matsue Y, et al:Time-to-furosemide treatment and mortality in patients hospitalized with acute heart failure. J Am Coll Cardiol 69:3042-3051, 2017
9)Yancy CW, et al:2013 ACCF/AHA guideline for the management of heart failure;A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 62:e147-e239, 2013
10)Prins KW, et al:Effects of Beta-Blocker withdrawal in acute decompensated heart failure;A systematic review and meta-analysis. JACC Heart Fail 3:647-653, 2015
11)Ponikowski P, et al:2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure;The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC) Developed with the special contribution of the Heart Failure Association(HFA)of the ESC. Eur Heart J 37:2129-2200, 2017

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1189

印刷版ISSN:0025-7699

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