Heart failure resistant to standard medical therapy

Payne, J. and Lang, N. (2014) Heart failure resistant to standard medical therapy. In: Smith, R., Higgins, M. and Macfie, A. (eds.) Cardiothoracic Critical Care. Series: Oxford specialist handbooks in critical care. Oxford University Press. ISBN 9780199692958 (doi: 10.1093/med/9780199692958.003.0021)

Abstract

This chapter discusses the assessment and general management of patients with decompensated heart failure where standard medical therapy is failing and more advanced options are required. Assessment, with an emphasis on identification of at-risk individuals and early consultation with specialist units, is discussed in detail. The chapter then describes general principles of management including oxygenation, fluid removal, vasodilators, inotropes, and arrhythmias. It goes on to consider escalation to the various forms of mechanical support (intra-aortic balloon pump counter-pulsation (IABP), short- and long-term ventricular assist devices, extracorporeal membrane oxygenation) and cardiac transplantation. It ends with a discussion of end of life care and a consideration of the principles of weaning support in the recovering patient.

• Item Type: Book Sections
• Status: Published
• Glasgow Author(s) Enlighten ID: Lang, Professor Ninian
• Authors: Payne, J., and Lang, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Publisher: Oxford University Press
• ISBN: 9780199692958