Abstract
Heart failure is a growing healthcare problem. Patients with advanced congestive heart failure are often admitted to the intensive care units. History taking and clinical examination can confirm the heart failure diagnosis in the majority of patients. Treatment strategies should be based on the underlying pathophysiology, aiming to reverse the haemodynamic abnormalities detected. Medical therapy aims at reducing venous congestion, optimising afterload, inotropic support, and anticoagulation. When medical therapy fails heart transplantation or mechanical circulatory support should be considered. Intra-aortic balloon conterpulsation, extracorporeal membrane oxygenation, short-term ventricular assist devices and percutaneous continuous flow systems can bridge patients to recovery or heart transplantation. Management of critically ill heart failure patients should involve multidisciplinary teams and includes nutrition, mobilisation, physiotherapy, infection control, correction of anaemia, electrolyte abnormalities, thyroid and adrenal function, as well as anticoagulation. Psychological and family support is important in patients where life style is likely to be dramatically changed or life expectancy shortened.
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Valchanov, K. (2014). Assessment and Management of Circulatory Failure. In: Gullo, A. (eds) Anaesthesia, Pharmacology, Intensive Care and Emergency A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-5516-2_3
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DOI: https://doi.org/10.1007/978-88-470-5516-2_3
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