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The following is a summary of “Management of Heart Failure and Cardiogenic Shock: The International RAND Appropriateness Committee” published in the April 2024 issue. Critical care According to Williams et al.


Researchers prospectively identify areas of agreement and disagreement in the care of patients with heart failure cardiogenic shock (HF-CS) admitted to the critical care setting, with the aim of informing current practice and future clinical trials. conducted research.

They convened a 16-member multinational expert committee. We conducted a study containing 34 statements using a modified RAND/UCLA appropriateness methodology. Each participant anonymously rated the suitability of each statement on a scale of 1 to 9 (1 to 3 inappropriate, 4 to 6 uncertain, and 7 to 9 appropriate).

The results showed 34 statements, of which 20 were deemed appropriate and 14 were deemed inappropriate. Uncertainty was prevalent across all three of his areas: initial assessment and management of HF-CS, transition to temporary mechanical circulatory support (tMCS), and weaning from tMCS in HF-CS. Notable disagreement among experts (indicated by a discrepancy index >1) occurred only regarding the effectiveness of chest ultrasound in immediate HF-CS management.

The researchers concluded that large prospective studies are important to establish best practices and future guidelines for patients with HF-CS.

sauce: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04884-5

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