Semi-quantitative pulmonary congestion score: prevalence and diuretic management implications after heart failure discharge

F.J. Pastor-Pérez, M. Veas-Porlán, N. Fernández-Villa, I.P. Garrido-Bravo, S. Manzano-Fernández, D.A. Pascual-Figal
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Abstract

Introduction

Persistent congestion after heart failure (HF) discharge is associated with a higher risk of readmissions.

Material and methods

eighty-two patients included after HF discharge. The aim of the study was to characterize semiquantitatively the degree of pulmonary congestion and its changes, describing the relationship between these findings and diuretic management.

Results

On the first visit, despite the absence of clinical congestion in the majority of patients, half of the had some degree of pulmonary congestion by ultrasound. After global assessment in this initial visit (clinical and ultrasound) the diuretic was lowered in 50 patients (60%), kept the same in 16 (20%) and it was increased in the rest. In the 45 patients without ultrasound congestion, diuretic reduction was attempted in 80%, being this strategy successful in the majority of them.

Conclusions

Lung ultrasound, using simple quantification methods, allows its real incorporation into clinical practice, helping us in the decision making process.

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半定量肺充血评分:心力衰竭出院后的发病率和利尿剂管理影响。
导言心力衰竭(HF)出院后持续充血与再入院的风险较高有关。研究目的是对肺充血程度及其变化进行半定量分析,描述这些结果与利尿剂管理之间的关系:在首次就诊时,尽管大多数患者没有临床充血症状,但半数患者经超声检查有一定程度的肺充血。在首次就诊时进行全面评估(临床和超声)后,50 名患者(60%)的利尿剂用量减少,16 名患者(20%)的利尿剂用量保持不变,其余患者的利尿剂用量增加。在 45 名未出现超声波充血的患者中,80% 的患者尝试减少了利尿剂用量,其中大部分患者的策略都取得了成功:结论:肺部超声波采用简单的量化方法,可以真正应用于临床实践,帮助我们做出决策。
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