Key result
Nonpharmacologic approaches, including physiologic management, cardiopulmonary manipulation, and mechanical circulatory support, are highlighted for managing severe acute heart failure in critically ill children.
This review highlights the importance of nonpharmacologic approaches, including mechanical circulatory support and physiologic optimization, in managing acute heart failure in critically ill children.
May inform care for critically ill children with acute heart failure; leaves open the need for prospective validation.
Acute heart failure is unusual in the pediatric population, but in many situations it justifies aggressive therapy. For example, children with lymphocytic myocarditis have an overall survival rate of nearly 90%, with complete myocardial recovery for the majority. Pharmacologic agents traditionally have been the mainstay of medical therapy for acute heart failure, but, in recent years, there has been increasing interest in using measures that reduce the myocardial workload. This article highlights nonpharmacologic approaches to the management of severe heart failure in the critically ill child. It also concentrates on physiologic approaches that address the balance between oxygen demand and delivery; the manipulation of cardiopulmonary interactions to optimize ventricular function; and the use of mechanical circulatory support as a method of achieving ultimate myocardial rest.
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Lara Shekerdemian (2001) conducted a review in Acute heart failure in critically ill children. Nonpharmacologic approaches (physiologic approaches, cardiopulmonary interactions, mechanical circulatory support) was evaluated. Nonpharmacologic approaches, including physiologic management, cardiopulmonary manipulation, and mechanical circulatory support, are highlighted for managing severe acute heart failure in critically ill children.
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