Cardiovascular
Payal Gurnani, BCCCP, BCPS, PharmD
Clinical Pharmacy Specialist, Cardiovascular ICU
Memorial Hermann Healthcare System
Houston, Texas
The prevalence of heart failure continues to rise and there is increasing sensitivity to the idea that patients with acute heart failure in the ICU should be treated not only with acute goals but with an eye to starting chronic therapies that have been shown to improve outcome. Studies have shown that components of guideline-directed medical therapy (GDMT) not started in the hospital are rarely initiated outside (10%-20%) as opposed to a 70%-80% continuation rate of these therapies when started in the hospital. Thus, increased sensitivity to the landscape of current heart failure management is valuable to the critical care community. This session will review the updated universal definition of heart failure, with standardization of the definition, a refined classification of ejection fraction, and better delineation of trajectories. New therapies, including new inotropes and new components of guideline-directed medical therapy, will be reviewed along with the trial data supporting their use. Specific strategies for stratifying risk, defining clinical trajectories, and implementing therapy during the course of a heart failure admission will also be discussed.