Management of acute atrial fibrillation in the intensive care unit: An international survey

被引：14

作者：

Wetterslev, Mik ^{[1
]}

Moller, Morten Hylander ^{[1
]}

Granholm, Anders ^{[1
]}

Hassager, Christian ^{[2
]}

Haase, Nicolai ^{[1
]}

Aslam, Tayyba Naz ^{[3
]}

Shen, Jiawei ^{[4
]}

Young, Paul J. ^{[5
,6
,7
]}

Aneman, Anders ^{[8
,9
]}

Hastbacka, Johanna ^{[10
,11
]}

Siegemund, Martin ^{[12
,13
]}

Cronhjort, Maria ^{[14
]}

Lindqvist, Elin ^{[14
]}

Myatra, Sheila N. ^{[15
]}

Kalvit, Kushal ^{[15
]}

Arabi, Yaseen M. ^{[16
]}

Szczeklik, Wojciech ^{[17
]}

Sigurdsson, Martin, I ^{[18
,19
]}

Balik, Martin ^{[20
]}

Keus, Frederik ^{[21
]}

Perner, Anders ^{[1
]}

机构：

[1] Copenhagen Univ Hosp, Rigshosp, Dept Intens Care, 4131,Blegdamsvej 9, DK-2100 Copenhagen, Denmark

[2] Copenhagen Univ Hosp, Rigshosp, Dept Cardiol, Copenhagen, Denmark

[3] Oslo Univ Hosp, Rikshosp, Dept Anaesthesiol, Div Emergencies & Crit Care, Oslo, Norway

[4] Peking Univ Peoples Hosp, Dept Crit Care Med, Beijing, Peoples R China

[5] Wellington Hosp, Intens Care Unit, Wellington, New Zealand

[6] Med Res Inst New Zealand, Wellington, New Zealand

[7] Monash Univ, Australian & New Zealand Intens Care Res Ctr, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia

[8] Univ New South Wales, Liverpool Hosp, South Western Sydney Local Hlth Dist, Dept Intens Care Med, Sydney, NSW, Australia

[9] Univ New South Wales, South Western Sydney Clin Sch, Sydney, NSW, Australia

[10] Univ Helsinki, Dept Anaesthesiol Intens Care & Pain Med, Helsinki, Finland

[11] Helsinki Univ Hosp, Helsinki, Finland

[12] Univ Hosp Basel, Dept Intens Care Med, Dept Clin Res, Basel, Switzerland

[13] Univ Basel, Basel, Switzerland

[14] Karolinska Inst, Dept Clin Sci & Educ, Sect Anaesthesia & Intens Care, Sodersjukhuset, Stockholm, Sweden

[15] Homi Bhabha Natl Inst, Tata Mem Hosp, Dept Anaesthesiol Crit Care & Pain, Mumbai, Maharashtra, India

[16] King Saud Bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, Dept Intens Care Med, Minist Natl Guard Hlth Affairs, Riyadh, Saudi Arabia

[17] Jagiellonian Univ Med Coll, Ctr Intens Care & Perioperat Med, Krakow, Poland

[18] Natl Univ Hosp Iceland, Landspitali, Div Anaesthesia & Intens Care, Perioperat Serv, Reykjavik, Iceland

[19] Univ Iceland, Fac Med, Reykjavik, Iceland

[20] Charles Univ Prague, Gen Univ Hosp, Fac Med 1, Dept Anesthesiol & Intens Care, Prague, Czech Republic

[21] Univ Groningen, Univ Med Ctr Groningen, Dept Crit Care, Groningen, Netherlands

来源：

ACTA ANAESTHESIOLOGICA SCANDINAVICA | 2022年 / 66卷 / 03期

关键词：

anticoagulant therapy; atrial fibrillation; intensive care unit; management strategies; CRITICALLY-ILL PATIENTS; CRITICAL ILLNESS; RISK-FACTORS; MORTALITY; OUTCOMES; ANTICOAGULATION; ASSOCIATION; ARRHYTHMIAS; THROMBOEMBOLISM; EPIDEMIOLOGY;

D O I：

10.1111/aas.14007

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Background Atrial fibrillation (AF) is common in intensive care unit (ICU) patients and is associated with poor outcomes. Different management strategies exist, but the evidence is limited and derived from non-ICU patients. This international survey of ICU doctors evaluated the preferred management of acute AF in ICU patients. Method We conducted an international online survey of ICU doctors with 27 questions about the preferred management of acute AF in the ICU, including antiarrhythmic therapy in hemodynamically stable and unstable patients and use of anticoagulant therapy. Results A total of 910 respondents from 70 ICUs in 14 countries participated in the survey with 24%-100% of doctors from sites responding. Most ICUs (80%) did not have a local guideline for the management of acute AF. The preferred first-line strategy for the management of hemodynamically stable patients with acute AF was observation (95% of respondents), rhythm control (3%), or rate control (2%). For hemodynamically unstable patients, the preferred strategy was observation (48%), rhythm control (48%), or rate control (4%). Overall, preferred antiarrhythmic interventions included amiodarone, direct current cardioversion, beta-blockers other than sotalol, and magnesium in that order. A total of 67% preferred using anticoagulant therapy in ICU patients with AF, among whom 61% preferred therapeutic dose anticoagulants and 39% prophylactic dose anticoagulants. Conclusion This international survey indicated considerable practice variation among ICU doctors in the clinical management of acute AF, including the overall management strategies and the use of antiarrhythmic interventions and anticoagulants.

引用

页码：375 / 385

页数：11

共 39 条

[11] Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibrillation [J].