RESPIRATORY FAILURE AS A COMPLICATION OF ACUTE HEART FAILURE

Respiratory failure (RF) is a common and serious complication in patients with acute heart failure (AHF). This article discusses the mechanisms underlying RF development in the context of AHF, as well as its clinical manifestations, diagnostic approaches, and treatment strategies. Particular attention is paid to pathophysiology, including the effects on pulmonary hemodynamics and gas exchange. The literature search was conducted in the MEDLINE/PubMed, EMBASE (Excerpta Medica), Cochrane Central Register of Controlled Trials databases, as well as in the Russian Registry of Controlled Trials, for the period from January 1, 2015, to January 10, 2025. The following search terms were used: “high-flow nasal cannula”, “acute heart failure”, “respiratory failure”, and “non-invasive ventilation”. The review included case series, retrospective and prospective cohort studies, and randomized trials addressing the diagnosis and treatment of RF in patients with AHF. Current treatment modalities were analyzed in detail, including invasive mechanical ventilation (IMV), non-invasive ventilation (NIV), and high-flow oxygen therapy (HFOT) delivered through nasal cannulas. NIV has proven to be an effective method for improving gas exchange and reducing cardiovascular workload. HFOT, in turn, provides respiratory support with minimal patient discomfort and may be used as an alternative to conventional ventilation methods. The results of clinical studies highlighting the importance of early diagnosis and a comprehensive approach to the management of patients with concomitant AHF and RF are discussed. Keywords: Acute heart failure, respiratory failure, high-flow oxygen therapy, invasive mechanical ventilation, non-invasive ventilation.