Abstract
Heart failure is a serious condition affecting an estimated 2 million Americans and is a common reason for hospitalization. Patients presenting with an acute deterioration of cardiac function are often admitted to the ICU. These patients are likely to benefit from treatment in an ICU. However, patients with end-stage cardiac failure whose condition has progressed slowly and inexorably despite maximal medical therapy are poor candidates for admission to the ICU, unless they are candidates for cardiac transplantation or have suffered from an acute medical complication. The following patients with cardiac failure may benefit from admission to an ICU:
-
Worsening pulmonary edema with acute respiratory failure
-
Acute myocardial ischemia
-
Acute hemodynamic compromise due to arrhythmias
-
Severe complicating disease, e. g., pneumonia
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Selected References
A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) investigators. N Engl J Med. 1997;337:1576–1583.
CAST investigators. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med. 1989;321:406–412.
CIBIS investigators. A randomized trial of beta-blockade in heart failure: The cardiac insufficiency bisoprolol study. Circulation. 1994;90:1765–1773.
CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Engl J Med. 1987;316:1429–1435.
Davies SW, Bailey J, Keegan J, et al. Reduced pulmonary microvascular permeability in severe chronic left heart failure. Am Heart J. 1992;124:137–142.
Dries F, Krell MJ, Whitloe, et al. Intermittent dobutamine in ambulatory patients with chronic heart failure. Circulation. 1986;74(suppl 11):11–38.
The effect of digoxin on mortality and morbidity in patients with heart failure. The Digitalis Investigation Group. N Engl J Med. 1997;336 (8):525–533.
Eichhorn EJ. Restoring function in failing hearts: the effects of beta blockers. Am J Med. 1998;104:163–169.
Galve E, Rius T, Ballester, et al. Intravenous amiodarone in treatment of recent-onset atrial fibrillation: results of a randomized, controlled study. J Am Coll Cardiol. 1996;27:1079–1082.
Marantz PR, Tobin JN, Wassertheil-Smoller S, Steingart RM, Wexler JP, Budner N, Lense L, Wachspress J. The relationship between left ventricular systolic function and congestive heart failure diagnosed by clinical criteria. Circulation. 1988;77(3):607–612.
Moss AJ, Hall WJ, Cannon DS, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmias. N Engl J Med. 1996;335:1933–1940.
O’Connor CM, Carson PE, et al. Effect of amlodipine on mode of death among patients with advanced heart failure in the PRAISE trial. Prospective Randomized Amlodipine Survival Evaluation. Am J Cardiol. 1998;82(7):881–887.
Packer M, Bristow MR, et al. The effect of Carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. N Engl J Med. 1996;334(21):1349–1355.
Packer M, Gheorghiade M, Young JB, et al. Withdrawl of digoxin from patients with chronic heart failure treated with angiotensin-converting- enzyme inhibitors. N Engl J Med. 1993;329:1–7.
Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. NEnglJ Med. 1999;341:709–717.
Sharpe N, Murphy J, Smith H, Hannan S. Treatment of patients with symptomless left ventricular dysfunction after myocardial infarction. Lancet. 1988;1:255–259.
Singh SN, Fletcher RD, Fisher SG, et al. Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. N Engl J Med. 1995;333:77–82.
SOLVD Investigators. Effect of enalapril on mortality and development of heart failure in asymptomatic patients with reduced left ventricular ejection fraction. N Engl J Med. 1992;327:685–691.
Stampfer M, Epstein SE, Beiser GD, Braunwald E. Hemodynamic effects of diuresis at rest and during intense upright exercise in patients with impaired cardiac function. Circulation. 1968;37:900–911.
Topol EJ, Traill TA, Fortuin NJ. Hypertensive hypertrophic cardiomyopathy of the elderly. N Engl J Med. 1985;312:2177–2287.
Waagstein F, Bristow MR, Swedberg K, et al. Beneficial effects of meto- prolol in idiopathic cardiomyopathy. Lancet. 1993;342:1441–1446.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2001 Springer-Verlag New York, Inc.
About this chapter
Cite this chapter
Marik, P.E. (2001). Management of Cardiac Failure in the Intensive Care Unit. In: Handbook of Evidence-Based Critical Care. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-86943-3_23
Download citation
DOI: https://doi.org/10.1007/978-3-642-86943-3_23
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-78093-9
Online ISBN: 978-3-642-86943-3
eBook Packages: Springer Book Archive