💔 Acute Heart Failure Profiling & Management
This tool profiles acute heart failure by perfusion (warm/cold) and congestion (wet/dry) and directs diuresis, vasodilation, and inotrope use accordingly.
Clinical takeaway
In hypoperfused patients, diuresis is deferred until adequate perfusion is restored, and vasodilators are avoided when SBP < 90. (original synthesis · not guideline verbatim)
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When to use
Use at the bedside to assign one of four hemodynamic profiles and choose targeted therapy, with general oxygen/ventilation and precipitant correction.
How it works
Warm-wet → loop diuretic + vasodilator (if SBP > 110); cold-wet → inotrope (± vasopressor) then diuresis, especially if SBP < 90; warm-dry → optimize oral drugs; cold-dry → cautious volume management.
Key points
- In hypoperfused patients, diuresis is deferred until adequate perfusion is restored, and vasodilators are avoided when SBP < 90. (original synthesis · not guideline verbatim)
- Warm-wet is the most common profile and responds to decongestion plus afterload reduction.
- Noninvasive ventilation is used for acute pulmonary edema/respiratory distress, and morphine is not routine.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Peripheral perfusion | Well perfused (warm) |
|---|---|
| Congestion | Congested (wet: pulmonary crackles, edema, JVD) |
| Systolic BP (optional) | 100 mmHg |
→Clinical profileWarm-wet (good perfusion + congestion, most common)
- Targeted management：IV loop diuretic (furosemide) for decongestion; if BP allows (SBP > 110) add a vasodilator (nitroglycerin/nitroprusside) to reduce pre/afterload; hypertensive pulmonary edema centers on aggressive vasodilation/BP reduction
- General：Semi-recumbent; oxygen if SpO₂ < 90%, noninvasive ventilation for acute pulmonary edema/respiratory distress (RR > 25); continuous BP and ECG monitoring; morphine not routine
- Cause/precipitant：Rapidly identify and treat precipitants: acute coronary syndrome, tachy/bradyarrhythmias, infection, abrupt BP rise, non-adherence or drug discontinuation, worsening renal function, etc.
| Peripheral perfusion | Hypoperfused (cold: cool limbs, oliguria, confusion, narrow pulse pressure) |
|---|---|
| Congestion | Not congested (dry) |
| Systolic BP (optional) | 100 mmHg |
→Clinical profileCold-dry (hypoperfusion, no congestion)
- Targeted management：Carefully assess volume, a cautious fluid challenge if needed; inotrope for persistent hypoperfusion; avoid over-diuresis
- General：Semi-recumbent; oxygen if SpO₂ < 90%, noninvasive ventilation for acute pulmonary edema/respiratory distress (RR > 25); continuous BP and ECG monitoring; morphine not routine
- Cause/precipitant：Rapidly identify and treat precipitants: acute coronary syndrome, tachy/bradyarrhythmias, infection, abrupt BP rise, non-adherence or drug discontinuation, worsening renal function, etc.
Frequently asked questions
- What is Acute Heart Failure Profiling & Management?
- This tool profiles acute heart failure by perfusion (warm/cold) and congestion (wet/dry) and directs diuresis, vasodilation, and inotrope use accordingly.
- How is Acute Heart Failure Profiling & Management calculated? What is the core formula?
- Warm-wet → loop diuretic + vasodilator (if SBP > 110); cold-wet → inotrope (± vasopressor) then diuresis, especially if SBP < 90; warm-dry → optimize oral drugs; cold-dry → cautious volume management.
- When is Acute Heart Failure Profiling & Management used?
- Use at the bedside to assign one of four hemodynamic profiles and choose targeted therapy, with general oxygen/ventilation and precipitant correction.
- What are the key clinical points for Acute Heart Failure Profiling & Management?
- In hypoperfused patients, diuresis is deferred until adequate perfusion is restored, and vasodilators are avoided when SBP < 90. (original synthesis · not guideline verbatim) Warm-wet is the most common profile and responds to decongestion plus afterload reduction. Noninvasive ventilation is used for acute pulmonary edema/respiratory distress, and morphine is not routine.
- What are the limits and cautions when using Acute Heart Failure Profiling & Management?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Acute Heart Failure Profiling & Management calculated in practice? Can you show a worked example?
- Inputs: Peripheral perfusion Well perfused (warm), Congestion Congested (wet: pulmonary crackles, edema, JVD), Systolic BP (optional) 100 mmHg → Result: Clinical profile Warm-wet (good perfusion + congestion, most common)（Targeted management: IV loop diuretic (furosemide) for decongestion; if BP allows (SBP > 110) add a vasodilator (nitroglycerin/nitroprusside) to reduce pre/afterload; hypertensive pulmonary edema centers on aggressive vasodilation/BP reduction, General: Semi-recumbent; oxygen if SpO₂ < 90%, noninvasive ventilation for acute pulmonary edema/respiratory distress (RR > 25); continuous BP and ECG monitoring; morphine not routine, Cause/precipitant: Rapidly identify and treat precipitants: acute coronary syndrome, tachy/bradyarrhythmias, infection, abrupt BP rise, non-adherence or drug discontinuation, worsening renal function, etc.） Inputs: Peripheral perfusion Hypoperfused (cold: cool limbs, oliguria, confusion, narrow pulse pressure), Congestion Not congested (dry), Systolic BP (optional) 100 mmHg → Result: Clinical profile Cold-dry (hypoperfusion, no congestion)（Targeted management: Carefully assess volume, a cautious fluid challenge if needed; inotrope for persistent hypoperfusion; avoid over-diuresis, General: Semi-recumbent; oxygen if SpO₂ < 90%, noninvasive ventilation for acute pulmonary edema/respiratory distress (RR > 25); continuous BP and ECG monitoring; morphine not routine, Cause/precipitant: Rapidly identify and treat precipitants: acute coronary syndrome, tachy/bradyarrhythmias, infection, abrupt BP rise, non-adherence or drug discontinuation, worsening renal function, etc.）