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Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
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Decompensated right heart failure, intensive care and perioperative management in patients with pulmonary

Karen M Olsson1, Michael Halank2, Benjamin Egenlauf3

  • 1Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany, German Centre for Lung Research (DZL), Germany.

International Journal of Cardiology
|September 8, 2018
PubMed

Insights

This consensus report updates 2018 recommendations for managing decompensated right heart failure (RHF) and perioperative care in pulmonary hypertension patients. It integrates new evidence and country-specific factors for practical clinical guidance.

Area of Science:

  • Cardiology
  • Pulmonology
  • Intensive Care Medicine

Background:

  • Pulmonary hypertension (PH) necessitates updated management strategies, especially concerning right heart failure (RHF) and perioperative care.
  • Existing European guidelines require adaptation for practical implementation, considering country-specific factors and recent evidence.
  • Consensus among German cardiology, respiratory medicine, and pediatric cardiology societies is crucial for refining clinical practice.

Purpose of the Study:

  • To develop consensus-based practice recommendations for decompensated right heart failure (RHF) in patients with pulmonary hypertension.
  • To provide updated guidance on intensive care and perioperative management for patients with pulmonary hypertension.
  • To integrate the latest evidence and country-specific considerations into practical clinical recommendations.

Main Methods:

  • A consensus conference was convened in June 2016 by leading German medical societies.
  • Recommendations were based on the 2015 European Pulmonary Hypertension guidelines, incorporating new evidence.
  • The working group focused on decompensated RHF, intensive care, and perioperative management.

Main Results:

  • The article details updated recommendations for RHF management, including pathophysiology, diagnosis, monitoring, and supportive therapies.
  • Specific therapeutic strategies discussed include volume management, PAH-targeting therapy, inotropes, vasopressors, and extracorporeal support.
  • Guidance is provided on preoperative management, intraoperative monitoring, and anesthetic choices for PH patients.

Conclusions:

  • The updated 2018 recommendations offer practical guidance for managing decompensated RHF in PH patients.
  • Comprehensive strategies for intensive care and perioperative management are outlined to improve patient outcomes.
  • This consensus aims to enhance the clinical implementation of evidence-based practices in Germany.

Keywords:
DecompensationIntensive carePerioperative managementPulmonary hypertensionRight heart failure

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