急性心力衰竭的当代管理:从急诊就诊到长期缓解
本文是一篇国际专家协作综述,旨在提供急性心力衰竭管理的更新实用综合,涵盖早期诊断评估、减充血策略、指南导向药物治疗启动及门诊过渡规划。目标是构建整合、整体、以患者为中心的护理路径,促进及时识别和获取指南导向药物治疗,提供全球广泛临床环境下适用的指导。
要点
- 强调及时、结构化、以患者为中心的急性心衰管理路径。
- 管理涵盖从早期诊断评估、减充血到指南导向药物治疗启动及门诊过渡。
- 推荐应反映多样化医疗需求并应对管理中的关键挑战。
核心结论
- 需要重新思考急性心衰的识别和管理方式,以应对其临床和经济负担的持续增长。
- 本文提供从早期诊断评估到长期缓解的整合、整体、以患者为中心的护理路径。
研究设计与样本
- 本文为综述,由国际临床专家小组协作完成,旨在提供全球广泛临床环境下适用的指导。
临床怎么用
- 临床应遵循结构化路径,及时识别急性心衰并启动指南导向药物治疗。
- 管理应涵盖减充血策略及规划门诊过渡,确保护理连续性。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
原文
Acute heart failure (AHF) represents a major global health challenge, with a substantial impact on survival, morbidity, and health care resource utilization. The clinical and economic burden associated with this condition continues to grow, highlighting the need for a timely, structured, and patient-centered approach to care. In light of the expanding body of data and evidence accumulated over recent years, it is necessary to rethink how we approach the recognition and management of AHF. This need has motivated the development of the present review, which aims to provide an updated and practical synthesis of the management of AHF-from early diagnostic assessment and decongestive strategies to the initiation of guideline-directed medical therapy and planning for outpatient transition. The goal is to outline an integrated, holistic, and patient-centered care pathway to facilitate timely recognition and access to guideline-directed medical therapies for AHF. This document is the result of collaboration among an international panel of clinicians with expertise in AHF management. The aim is to offer guidance that is globally applicable across a wide range of clinical settings. Particular attention has been paid to ensuring that the proposed recommendations reflect diverse health care needs while addressing key challenges and threats in the management of patients with AHF. By aligning clinical strategies with patient needs and system capabilities, this review seeks to advance the quality and consistency of AHF care worldwide.
引用
- Bruno, Arrigo, Baudry, et al. Contemporary Management of Acute Heart Failure: From Emergency Presentation to Long-Term Remission. J Am Coll Cardiol. 2026. PMID: 42201275. doi:10.1016/j.jacc.2026.03.029
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。