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| {{Congestive heart failure}}
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| {{CMG}}; {{AOEIC}} {{LG}}
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| ==Overview==
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| * Based upon the results of the ESCAPE trial, there is no benefit in clinical outcomes with the use of a pulmonary artery line in patients with decompensated CHF.
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| ==ACC/AHA Guidelines- Invasive Hemodynamic Monitoring (DO NOT EDIT) <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>==
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| {{cquote|
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| ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]===
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| '''1.''' Invasive hemodynamic monitoring should be performed to guide therapy in patients who are in [[respiratory distress]] or with clinical evidence of impaired perfusion in whom the adequacy or excess of intracardiac filling pressures cannot be determined from clinical assessment. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''
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| ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]===
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| '''1.''' Invasive hemodynamic monitoring can be useful for carefully selected patients with acute [[heart failure]] who have persistent symptoms despite empiric adjustment of standard therapies, and ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''
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| :'''a.''' whose fluid status, perfusion, or systemic or pulmonary vascular resistances are uncertain,
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| :'''b.''' whose systolic pressure remains low, or is associated with symptoms, despite initial therapy,
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| :'''c.''' whose [[renal dysfunction|renal function is worsening]] with therapy
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| :'''d.''' who require parenteral [[Congestive heart failure positive inotropics|vasoactive agents]] or
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| :'''e.''' who may need consideration for advanced device therapy or [[Congestive heart failure cardiac transplantation|transplantation]].
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| ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]===
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| '''1.''' Routine use of invasive hemodynamic monitoring in normotensive patients with acute [[decompensated HF]] and congestion with symptomatic response to [[Congestive heart failure diuretics|diuretics]] and [[Congestive heart failure vasodilators|vasodilators]] is not recommended. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''}}
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| ==Vote on and Suggest Revisions to the Current Guidelines==
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| *[[The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
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| ==Guidelines Resources==
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| *[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>
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| *[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="pmid16160202">Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16160202 ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society.] ''Circulation'' 112 (12):e154-235. [http://dx.doi.org/10.1161/CIRCULATIONAHA.105.167586 DOI:10.1161/CIRCULATIONAHA.105.167586] PMID: [http://pubmed.gov/16160202 16160202]</ref>
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| ==References==
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| {{Reflist|2}}
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| [[Category:Disease]]
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