@article{3145755,
    title = "Assessing and grading congestion in acute heart failure: a scientific
statement from the Acute Heart Failure Committee of the Heart Failure
Association of the European Society of Cardiology and endorsed by the
European Society of Intensive Care Medicine",
    author = "Gheorghiade, Mihai and Follath, Ferenc and Ponikowski, Piotr and Barsuk, and Jeffrey H. and Blair, John E. A. and Cleland, John G. and Dickstein, and Kenneth and Drazner, Mark H. and Fonarow, Gregg C. and Jaarsma, Tiny and and Jondeau, Guillaume and Lopez Sendon, Jose and Mebazaa, Alexander and and Metra, Marco and Nieminen, Markku and Pang, Peter S. and Seferovic, and Petar and Stevenson, Lynne W. and van Veldhuisen, Dirk J. and Zannad, and Faiez and Anker, Stefan D. and Rhodes, Andrew and McMurray, John J. V. and and Filippatos, Gerasimos",
    journal = "European Journal of Heart Failure",
    year = "2010",
    volume = "12",
    number = "5",
    pages = "423-433",
    publisher = "Wiley",
    doi = "10.1093/eurjhf/hfq045",
    keywords = "Acute heart failure; Congestion; Score; Risk assessment",
    abstract = "Patients with acute heart failure (AHF) require urgent in-hospital
treatment for relief of symptoms. The main reason for hospitalization is
congestion, rather than low cardiac output. Although congestion is
associated with a poor prognosis, many patients are discharged with
persistent signs and symptoms of congestion and/or a high left
ventricular filling pressure. Available data suggest that a
pre-discharge clinical assessment of congestion is often not performed,
and even when it is performed, it is not done systematically because no
method to assess congestion prior to discharge has been validated.
Grading congestion would be helpful for initiating and following
response to therapy. We have reviewed a variety of strategies to assess
congestion which should be considered in the care of patients admitted
with HF. We propose a combination of available measurements of
congestion. Key elements in the measurement of congestion include
bedside assessment, laboratory analysis, and dynamic manoeuvres. These
strategies expand by suggesting a routine assessment of congestion and a
pre-discharge scoring system. A point system is used to quantify the
degree of congestion. This score offers a new instrument to direct both
current and investigational therapies designed to optimize volume status
during and after hospitalization. In conclusion, this document reviews
the available methods of evaluating congestion, provides suggestions on
how to properly perform these measurements, and proposes a method to
quantify the amount of congestion present."
}