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1
Class Recommendations and Grade of Evidence
Level of Evidence A Data derived from multiple randomized trials of meta-analyses
Level of Evidence B Data derived from a single randomized clinical trial or non randomized studies
Level of Evidence C Consensus of opinion of experts and/or small studies
Arnold JMO et al. Can J Cardiol 2006(1)23-45.
2
Treatment Algorithm for Acute Heart Failure

• Moderate to severe volume overload
• inadequate response to IV diuretics
• increased oxygen requirement
• CPAP and BiPAP requirement
• fatigue

Mild volume overloaded

• SBP gt 90mmHg
• milrinone
• 0.275 µg/kg/min or
• dobutamine

• IV diuretics
• IV furosemide bolus
• serum creatinine lt200 µmol/L 40 mg
• serum creatininegt 200 µmol/L 80 mg