{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T20:58:25Z","timestamp":1775509105750,"version":"3.50.1"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,11,1]]},"abstract":"<jats:p>OBJECTIVE: The objectives of this study were to (1) describe the clinical presentation of acute heart failure syndromes (AHFS) in the pediatric emergency department (ED) and (2) determine the physician treatment regimens and outcomes in the same population.<\/jats:p>\n               <jats:p>METHODS: This was a cross-sectional study of patients who presented with AHFS to the ED at our institution from January 2003 to October 2006. We defined AHFS as \u201cthe gradual or rapid deterioration in heart failure signs and symptoms resulting in a need for urgent therapy.\u201d Patients were included when they had documented signs or symptoms of HF attributable to ventricular dysfunction. Patients were excluded when they were older than 21 years or had HF symptoms that were attributable to left-to-right intracardiac shunting or left-sided obstructive lesions. All eligible ED patient visits were adjudicated by a pediatric HF specialist.<\/jats:p>\n               <jats:p>RESULTS: Fifty-seven patient visits to the ED met inclusion criteria. There was a significant difference in time from arrival to treatment with a diuretic when the therapy was started in the ED rather than in the inpatient units. Median time to initiation of a vasoactive agent was significantly less for patients whose infusions were started in the ED compared with the ICU. Two patients died in the ED, and overall mortality or need for mechanical circulatory support for hospitalized patients was 18% (n = 10).<\/jats:p>\n               <jats:p>CONCLUSIONS: These data yield important insight into the clinical features and initial treatment of children who present with AHFS in the ED and may allow for improved recognition and treatment of this clinical syndrome.<\/jats:p>","DOI":"10.1542\/peds.2008-2198","type":"journal-article","created":{"date-parts":[[2009,10,20]],"date-time":"2009-10-20T01:25:57Z","timestamp":1256001957000},"page":"e898-e904","source":"Crossref","is-referenced-by-count":58,"title":["Acute Heart Failure Syndromes in the Pediatric Emergency Department"],"prefix":"10.1542","volume":"124","author":[{"given":"Scott M.","family":"Macicek","sequence":"first","affiliation":[{"name":"Department of Pediatrics, aLillie Frank Abercrombie Section of Pediatric Cardiology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles G.","family":"Macias","sequence":"additional","affiliation":[{"name":"Section of Emergency Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John L.","family":"Jefferies","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, aLillie Frank Abercrombie Section of Pediatric Cardiology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, aLillie Frank Abercrombie Section of Pediatric Cardiology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack F.","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, aLillie Frank Abercrombie Section of Pediatric Cardiology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2009,11,1]]},"reference":[{"key":"2021120905182017000_R1","doi-asserted-by":"crossref","unstructured":"Koelling TM, Chen RS, Lubwama RN, L'Italien GJ, Eagle KA. 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Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J.\u20082005;149(2):209\u2013216","DOI":"10.1016\/j.ahj.2004.08.005"},{"key":"2021120905182017000_R4","doi-asserted-by":"crossref","unstructured":"Zannad F, Briancon S, Juilliere Y, et al. Incidence, clinical and etiologic features, and outcomes of advanced chronic heart failure: the EPICAL Study. J Am Coll Cardiol.\u20081999;33(3):734\u2013742","DOI":"10.1016\/S0735-1097(98)00634-2"},{"key":"2021120905182017000_R5","doi-asserted-by":"crossref","unstructured":"Fonarow GC, Adams KF, Abraham WT, et al. Risk stratification for in-hospital mortality in acutely decompensated heart failure (classification and regression tree analysis). 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