2015年欧洲急性心衰院前与早期处理共识_精品.ppt

2015 HFA／ESC／EuSEM／SAEM建议： 急性心衰的院前和医院管理 谢文源 2015-12-30 CONTENTS 1.Deinition and epidemiology of acute heart failure 急性心衰的定义与流行病学特点 2.Prehospital and early management strategies in acute heart failure 急性心衰院前及早期治疗策略 3.Initial clinical evaluation and investigations 早期评估和治疗 4. Deinition, initial management and monitoring of cardiogenic shock 心源性休克诊疗的定义和要点 * 1.Deinition and epidemiology of acute heart failure 2.Prehospital and early management strategies in acute heart failure 3.Initial clinical evaluation and investigations 4. Deinition, initial management and monitoring of cardiogenic shock CONTENTS * 解决软件开发企业核心难题 2 ? Acute heart failure (AHF) is the term used to describe the rapid onset of, or acute worsening of symptoms and signs of HF, associated with elevated plasma levels of natriuretic peptides. ＡＨＦ定义为：心力衰竭症状急性发作或加重，并伴有血浆脑利钠肽水平的升高。 ? Most of the patients with AHF present with normal or high blood pressure and with symptoms and/or signs of congestion rather than low cardiac output. 与住院患者比较，急诊或院前 ＡＨＦ的特点在于，绝大多数患者的血压正常或升高，伴有肺淤血症状和体征，而不是低心输出量。 Deinition and epidemiology of acute heart failure Deinition and epidemiology of acute heart failure 1.Deinition and epidemiology of acute heart failure 2.Prehospital and early management strategies in acute heart failure 3.Initial clinical evaluation and investigations 4. Deinition, initial management and monitoring of cardiogenic shock CONTENTS * 急救战线前移： As for acute coronary syndromes, the “time-to-treatment” concept may be important in patients with AHF. Hence, all AHF patients should receive appropriate therapy as early as possible. 和急性冠脉综合征一样，应秉承“及时治疗”理念治疗。所有急性心衰患者均应尽早接受适宜的治疗。 * In the pre-hospital setting, AHF patients should benefit from: Noninvasive monitoring, including pulse oximetry, blood pressure, respiratory rate, and a continuous ECG, instituted within minutes of patient contact and in the ambulance if possible. Oxygen therapy given based on clinical judgment unless oxygen saturation90% in