ESC2012

12.AHF
AHF
AHF HF-REF
HF-PEF
AHF AHF 3

HF-REF
HF-PEF
19

AMI

19

/
ACS
ACS

AHF
12.3 12.4 ,
ICU CCU
HF-REF

12.1
4 , 3
(i) ? ()

(ii) ACS
(iii)

 122
4

SBP
SpO2 12.3 12.4

12.2.1
12.2.1.1

(SpO2<90%)
224

RCT 22 12
213
=2.5

/
ECG

/ / BP<85mmH /
a c d
b
g e

/
/
MCSIABP

MCS=IABP=
A<90%<60 mmHg (8.0kPa)
B
C15ml/h /
D ST
E

4

225226
15

227

20
218220

<110 mmHg
AHF

BNP
228


21

20

1020 g/min 200
g/min
1 mg/h 10 mg/h

0.3 g/kg/min 5
g/kg/min
a
2 g/kg+0.01 g/kg/min
A
-

21

 >5g/kg/min) <3g/kg/min
229

21

220 g/kg/min ( +)
<3g/kg/min:( +)
35 g/kg/min;( +)
>5 g/kg/min: ( +),( + )
2575 g/kg 1020 min 0.3750.75 g/kg/min
0.51.0 mg/kg 510min 520 g/kg/min
a b
12 g/kg 10 min () 0.1 g/kg/min, 0.05 0.2
g/kg/min
0.21.0 g/kg/min
1 mg i.v. 3-5min 0.050.5 g/kg/min

Ab 90 mmHg
a= ;b= ; =.


214-216
V2
230

12.2.1.2
ACEI/ARB
EF ACEI ARB
7.2.1 11

/
I B 231

<90% PaO2<60 mmHg (8.0 kPa) I C -

I A 214
216
>20 /min IIa B 217
CPAP
<85 mmHg
IIa C -

/>110 mmHg IIa B 218,

219

/>110 mmHg IIb B 220

AMI

<85 mmHg) III C -

 I C -

<85 mmHg)/ IIa C -

ECG
IIa C -

- IIb C -
- ECG

IIb C -
ECG

IIb C -

ACS
ST LBBB ACS PCI I A 221
CABG
PCI CABG PCI/CABG ST I A 222
LBBB
ST ACS PCI CABG I A 221
ACS
EF40% I B 107
EF40% ACEI ARB I A 101

EF40% - I B 223

IIa C -

I A 184

I C -

I C -
<48
TOE
I C -
EF40% III A 176

I III A 178

I C -

CPAP=LBBB=LMWH=

-
EF -
7.1 12
-

MRA
EF MRA 7.2
13 MRA


EF -

7.2.6
12.2.2 /
<2 g/d<1.5-2.0 L/d

22
ED/CCU/ICU

ICU

CCU=ED= ICU=

12.2.2.1
CPAPNIPPV

RCT
90%51%
217

12.2.2.2 MCS
IABP
IABP

IABP
231

13.5

1 2.5
2<90% PaO2 <60 mmHg (<8.0 kPa)
3 4060% SpO2 >90% CO2
448 mg 10 mg
5
6 2.5 g/kg/min
15 min >20 g/kg/min
-2
7/SpO2SBP
8 10 g/min 10 min
>100 g/min
9 2 >100 mL/h
1-2 h)

10
11
/
/

12 12 h <100 mL/h
13/


14
15 12.2.2.1
16
17 500 mg 4 h 250 mg

18 2.5
g/kg/min
19 17 18
5. /

MCS
13.5

12.2.2.3
232

12.3
12.3.1

12.3.2
AHF
233
(i)(ii)(iii)LV
(iv)
LV
LV /

12.4
24

RAS

12.5

19
12.6

234-236
48 -
 236
/
22