Patient selection: heart failure patient admitted to the ICU
Clinical status improved:
(1) dyspnea improved
(2) edema improved
(3) weight loss (> 3 kilograms)
(4) slowing of heart rate
(5) normalized blood pressure
(6) low serum concentration of natriuretic peptide
(7) GFR stable and > 60 mL per min per 1.73 square meter BSA
Optimized therapy:
(1) precipitating factor(s) under control
(2) comorbidities under control
(3) angiotensin converting enzyme (ACE) inhibitor and/or angiotensin receptor blocker
(4) beta-blocker therapy
(5) mineralocorticoid receptor antagonist
(6) diuretics
(7) anti-thrombotics
(8) diet
Other:
(1) post-discharge follow-up planned
Some additional items may be:
(1) to review the GOLD criteria for palliative care if the heart failure appears to be end-stage.
(2) to evaluate the patient for anxiety and depression
(3) to review social factors which may contribute to deterioration
