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Class Recommendations and Grade of Evidence

Class Recommendations and Grade of Evidence. Arnold JMO et al. Can J Cardiol 2006;(1):23-45. Treatment Algorithm for Acute Heart Failure. AHF diagnosed, treatment initiated based on symptoms and signs. Volume overloaded & low cardiac output. Volume overloaded.

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Class Recommendations and Grade of Evidence

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  1. Class Recommendations and Grade of Evidence Arnold JMO et al. Can J Cardiol 2006;(1):23-45.

  2. Treatment Algorithm for Acute Heart Failure AHF diagnosed, treatment initiated based on symptoms and signs Volume overloaded & low cardiac output Volume overloaded • Moderate to severe volume overload • inadequate response to IV diuretics • increased oxygen requirement • CPAP and BiPAP requirement • fatigue Mild volume overloaded • Very low output • consider PA line • add vasodilator after BP stabilized Mild to moderate low output • SBP < 90mmHg • dobutamine2-5 µg/kg/min • may also require vasopressors • IV diuretics & • IV vasodilators • consider furosemide infusion • add IV nitroglycerin starting at 5-10 µg/kg/min, titrate to clinical status, BP or PCWP, if available • SBP > 90mmHg • milrinone 0.275 µg/kg/min or • dobutamine • IV diuretics • IV furosemide bolus • serum creatinine<200µmol/L 40 mg • serum creatinine> 200µmol/L 80 mg

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