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Chronic Heart Failure

Hoffman, Timothy M. MD, FACC, FAHA

Pediatric Critical Care Medicine: August 2016 - Volume 17 - Issue 8 - p S119-S123
doi: 10.1097/PCC.0000000000000755
Organ Systems: Cardiopathophysiology and Disorders

Objectives: The objectives of this review are to discuss the paradigms used to stage heart failure in children, the classification and physiologic profile of cardiomyopathies, and the acute and chronic pharmacologic management of heart failure.

Data Source: MEDLINE, PubMed.

Conclusion: The etiology of chronic heart failure in pediatrics is vast. The paradigm of extrapolating adult clinical trials and technological advancements to treat heart failure in children has become a nonsustainable model. The field of pediatric heart failure continues to advance with more robust guideline-directed care and the imminent creation of a dynamic, contemporary international database. As the field involves a markedly heterogeneous patient population, it is imperative to use pediatric specific descriptors of disease impact. The fields of pediatric heart failure and critical care medicine will continue to evolve together as childhood specific registries, quality improvement guidelines, and research will lead to practice models eliciting optimal therapy for patients with heart failure in the intensive care setting.

Division of Cardiology, Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina Children’s Hospital, Chapel Hill, NC.

Dr. Hoffman disclosed off-label product use (inotropic medications in pediatrics).

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Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies