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The "CHEOPS" bundle for the management of Left Ventricular Diastolic Dysfunction in critically ill patients: an

Filippo Sanfilippo1, Antonio Messina2, Sabino Scolletta3

  • 1Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Catania, Italy; Department of General Surgery and Medico-Surgical Specialties, School of Anaesthesia and Intensive Care, University of Catania, Catania, Italy.

Anaesthesia, Critical Care & Pain Medicine
|July 29, 2023
PubMed

Insights

Left ventricular diastolic dysfunction (LVDD) impacts critically ill patients. The CHEOPS bundle offers a proactive management strategy for LVDD in intensive care units, improving patient outcomes.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Intensive Care Unit Management

Background:

  • Left ventricular diastolic dysfunction (LVDD) significantly impacts heart failure outcomes.
  • LVDD is increasingly recognized as a predictor of poor prognosis in critically ill intensive care unit (ICU) patients.
  • Current treatment options for LVDD in critically ill patients are limited, necessitating proactive management strategies.

Purpose of the Study:

  • To introduce a practical, bedside management bundle for critically ill patients with LVDD.
  • To provide physicians with a structured approach to optimize LVDD management in the ICU.
  • To enhance patient outcomes through a proactive, multidisciplinary strategy.

Main Methods:

  • Development of the CHEOPS (Chest Ultrasound, HEmodynamics, OPtimization of ventilation, Stabilization) bundle.
  • Integration of echocardiography and lung ultrasound for comprehensive assessment.
  • Systematic evaluation of hemodynamics, mechanical ventilation, pulmonary circulation, and fluid management.
  • Expert opinion-based recommendations for LVDD management during critical illness.

Main Results:

  • The CHEOPS bundle offers a framework for optimizing care in LVDD patients.
  • It emphasizes a proactive approach beyond initial resuscitation.
  • The bundle integrates multiple aspects of critical care to address LVDD.

Conclusions:

  • The CHEOPS bundle provides a structured, expert-recommended approach for managing LVDD in critically ill patients.
  • This proactive strategy aims to improve outcomes by optimizing diastolic function and overall hemodynamic stability.
  • Further validation and implementation studies are warranted to confirm the clinical utility of the CHEOPS bundle.

Keywords:
CongestionCritical careDiastolic functionDoppler echocardiographyHemodynamicsIntensive careLeft ventricleMechanical ventilationRight ventricle

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