Presentation Information
[I-IL1-1]From AHA Scientific Statement to Practice: ADHF in Children
○Antonio G. Cabrera (The Ohio State University, Nationwide Children's Hospital)
On this conference we will discuss the new American Heart Association scientific statement: Evaluation and Management of the Child With Acute Decompensated Heart Failure and delineates evidence‑informed best practices for the evaluation, management, and comprehensive care of pediatric patients presenting with acute decompensated heart failure (ADHF). ADHF is defined as either the initial clinical manifestation of heart failure or the acute deterioration of pre‑existing chronic heart failure, with symptom severity necessitating admission to an inpatient ward or intensive care unit. The syndrome may arise from myocardial impairment characterized by reduced contractile performance (systolic dysfunction), impaired ventricular relaxation (diastolic dysfunction), or a combination of both pathophysiological processes.
From a physiological perspective, ADHF represents a state in which cardiac output is insufficient to meet systemic metabolic demands, accompanied by elevated venous pressures that contribute to tissue congestion. If unrecognized or inadequately treated, this condition can progress to multiorgan dysfunction, including cardiorenal syndrome, and ultimately result in mortality.
Given the relative scarcity of high‑quality pediatric clinical trials to guide therapy, the recommendations presented integrate data from pediatric registries, population‑based studies, and relevant adult heart failure literature, supplemented by expert clinical consensus to address persistent knowledge gaps.
The intended audience comprises pediatric cardiologists, cardiac and pediatric intensivists, cardiac surgeons, and other healthcare professionals involved in the care of hospitalized children with ADHF. The statement reviews foundational principles of pediatric heart failure and critical care, with particular emphasis on their application to patients whose primary pathology is cardiovascular in origin.
References:
Cabrera AG, Price JF, Hong BJ, Jeewa A, Tabulov C, Wong SS, Reardon L, Kasparian NA, Amdani S; Young Hearts Pediatric Heart Failure and Transplantation Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention. Evaluation and Management of the Child With Acute Decompensated Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2026 May 12;153(19):e1323-e1335. doi: 10.1161/CIR.0000000000001428. Epub 2026 Apr 6. PMID: 41937629.
From a physiological perspective, ADHF represents a state in which cardiac output is insufficient to meet systemic metabolic demands, accompanied by elevated venous pressures that contribute to tissue congestion. If unrecognized or inadequately treated, this condition can progress to multiorgan dysfunction, including cardiorenal syndrome, and ultimately result in mortality.
Given the relative scarcity of high‑quality pediatric clinical trials to guide therapy, the recommendations presented integrate data from pediatric registries, population‑based studies, and relevant adult heart failure literature, supplemented by expert clinical consensus to address persistent knowledge gaps.
The intended audience comprises pediatric cardiologists, cardiac and pediatric intensivists, cardiac surgeons, and other healthcare professionals involved in the care of hospitalized children with ADHF. The statement reviews foundational principles of pediatric heart failure and critical care, with particular emphasis on their application to patients whose primary pathology is cardiovascular in origin.
References:
Cabrera AG, Price JF, Hong BJ, Jeewa A, Tabulov C, Wong SS, Reardon L, Kasparian NA, Amdani S; Young Hearts Pediatric Heart Failure and Transplantation Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention. Evaluation and Management of the Child With Acute Decompensated Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2026 May 12;153(19):e1323-e1335. doi: 10.1161/CIR.0000000000001428. Epub 2026 Apr 6. PMID: 41937629.