Comparison of Ambulatory, High-Dose, Intravenous Diuretic Therapy to Standard Hospitalization and Diuretic Therapy for Treatment of Acute Decompensated Heart Failure

Buckley, Leo F.; Seoane‐Vazquez, Enrique; Cheng, Judy; Aldemerdash, Ahmed; Cooper, Irene; Matta, Lina; Medina, D.S.; Mehra, Mandeep R.; Navarro-Velez, Kristina; Shea, Elaine L.; Weintraub, Joseph R.; Stevenson, Lynne Warner; Desai, Akshay S.

doi:10.1016/j.amjcard.2016.07.068

Cited by 16 publications

(2 citation statements)

References 18 publications

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“… [28] RM enhances the ability for clinicians to make therapeutic decisions about their patients and to consider novel interventions such as same-day infusion centers to administer intravenous diuretics for patients with volume overload. [29] , [30] In our current practice environment, we have become accustomed to using HF readmissions as a marker of poor hospital performance. Our findings suggest a need for improved measures of hospital quality.…”

Section: Discussionmentioning

confidence: 99%

Remote monitoring for heart failure: Assessing the risks of readmission and mortality

Johnson

Bilderback²,

Boninger³

et al. 2021

American Heart Journal Plus: Cardiology Research and Practice

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Section: Discussionmentioning

confidence: 99%

Remote monitoring for heart failure: Assessing the risks of readmission and mortality

Johnson

Bilderback²,

Boninger³

et al. 2021

American Heart Journal Plus: Cardiology Research and Practice

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“…Novi vodič ističe da u takvoj akutizaciji srčane insuficijencije, gde postoji rezistencija na diuretike peroralnim putem te loša intestinalna apsorpcija, obavezno treba rano dati intravenski diuretik a ukoliko je diureza slaba, zameniti ga drugim ili trećim diuretikom (furosemid vs bumetanid vs torasemid). U našeg bolesnika pokazana je rezistencija kako na peroralno davanje diuretika u hroničnoj srčanoj nsuficijenciji, tako i mnogo bolji odgovor na kasniju zamenu oralnog diuretika: bumetanida umesto furosemida, što su opisali i drugi autori [9,10,11] kao i genetski osnov rezistencije na određenu vrstu diuretika Henleove petlje [12]. Detaljna analiza dvodimenzijskih i Dopler parametara rutinski dobijena iz ehokardiografije može da pruži prognostičke informacije kod bolesnika koji imaju hroničnu srčanu insuficijenciju sa redukovanom sistolnom funkcijom to jest ejekcionom frakcijom leve komore ispod 40% [13].…”

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Unusually favorable course of chronic heart failure in patient with dilatative cardiomyopathy and very low left ventricular ejection fraction during three and a half year folow-up

Raščanin¹,

Arandjelovic²,

Bastać³

et al. 2017

Tim Med Glas

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(1) INTERNISTIČKA ORDINACIJA "DR BASTAĆ", KOSANČIĆEV VENAC BR.16, ZAJEČAR (2) ZDRAVSTVENI CENTAR ZAJEČAR Sažetak:Srčana insuficijencija predstavlja sindrom koji je posledica niza strukturnih srčanih oboljenja, zbog čega srce ne može da obezbedi dovoljno snabdevanje krvlju da bi se zadovoljile potrebe organizma za kiseonikom. Kod našeg bolesnika je prikazan tok dijagnostike i lečenja teške srčane inusficijencije kod bolesnika sa dilatacionom kardiomiopatijom mešovite etiologije (ishemijska, dijabetes, etilizam). Istaknut je značaj rezistencije kako na peroralno davanje diuretika u hroničnoj srčanoj insuficijenciji, tako i mnogo bolji odgovor na kasniju promenu vrste oralnog diuretika: bumetanida umesto furosemida. Bolesnik koji je naizgled bio u terminalnoj fazi srčane insuficijencije, sa idejom da mu se pomogne rekonstrukcijom mitralne valvule, terapijom autolognim matičnim ćelijama, implantacijom kardioverter defibrilatora i stavljanjem na listu za transplantaciju srca oporavljen je putem konvencionalne terapije za srčanu inuficijenciju. Prognoza pacijenta je značajno poboljšana, bez obzira na početnu procenu visokog godišnjeg mortaliteta Siettle Heart Failure Modelom. Detaljna analiza dvodimenzijskih i Dopler parametara rutinski dobijena iz ehokardiografije pružila je značajne prognostičke informacije kod ovog bolesnika. Ejekciona frakcija ovog bolesnika je uz optimalnu nefarmakološku i farmakološku terapiju zadovoljavajuće porasla za 3,5 godine za 14% (EF 18% vs 32 %) iako bez regresije dilatacije leve komore, ali uz redukciju veličine leve pretkomore i poboljšanje dijastolne disfunkcije. Terapija je data na osnovu preporuka evropskog vodiča za srčanu insuficijenciju iz 2016. godine: ACE inhibitor, betablokator, spironolacton, bumetanid, acetilsalicilna kiselina, statin, uz dobru regulaciju dijabeta i blagu fizičku aktivnost. Mada prospektivne kliničke studije još uvek nedostaju, korišćenje ehokardiografije u individualnom slučaju za praćenje uspeha terapije i za segregaciju rizika trebalo bi da bude uključeno u savremenu strategiju lečenja srčane insuficijencije i da ima uticaj na kliničko odlučivanje za transplantaciju srca. Ključne reči: srčana insuficijencija, dilataciona kardiomiopatija, redukovana sistolna funkcija leve komore Summary:Cardiac insufficiency represents a syndrome caused by a wide spectrum of structural heart diseases, which makes the heart unable to provide enough blood supply to meet the body's needs for oxygen. We can see the course of diagnostics and treatment of severe cardiac insufficiency in our patient who has previously been diagnosed with dilatational cardiomyopathy with mixed etiology (ischemic, diabetes, ethylism). There is a significant resistance to dispensation of peroral diuretics in chronic cardiac insufficiency and much better response to switching the type of oral diuretic: bumetanide instead of furosemide. The patient, who was, seemingly, in terminal phase of cardiac insufficiency with an idea to be treated by reconstruction of mitral valve, stem cells, cardioverter de...

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Outpatient treatment of decompensated heart failure: A systematic review and study level meta‐analysis

Bahar,

Rahman,

Wong

et al. 2024

ESC Heart Failure

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Patients with acutely decompensated heart failure (ADHF) are usually admitted to hospital for management. There is growing interest in delivering intravenous (IV) diuretic therapy at home, in the community or at hospital day‐care units; the safety and effectiveness of outpatient‐based management (OPM) for ADHF has not been established. We conducted a systematic literature review and meta‐analysis to investigate the short‐term safety and effectiveness of OPM compared with inpatient management (IPM) of ADHF. Pre‐specified endpoints were 30 day mortality and 30 day hospitalization. The meta‐analysis was conducted using RevMan 5.4 software. Twenty‐nine studies of OPM were identified, including 7683 patients. Only five studies directly compared OPM (n = 1303) with IPM (n = 2047), including three observational studies, and two randomized controlled trials (RCTs). The other 24 studies only stated OPM outcomes. For the five studies comparing IPM versus OPM, patients were generally aged >75 years and of similar age for each strategy, with a similar proportion of men (56%). In a study‐level, aggregate analysis, 30 day all‐cause mortality was 9.3% (121/1303) for OPM, compared with 15.6% (320/2047) for IPM [OR 0.29 (95% CI 0.09, 0.93) P = 0.04]. Four studies reported 30 day all‐cause hospitalization; 22.0% for IPM versus 16.8% for OPM [OR 0.73 (95% CI 0.61, 0.89), P = 0.001]. In the two RCTs, we found no difference in 30 day mortality or hospitalization. In observational studies, OPM of ADHF is associated with lower 30 day hospitalization and lower 30 day mortality; such differences were not observed in two small, single‐centre RCTs. A substantial, multicentre RCT is required to confirm the safety and effectiveness of OPM for ADHF.

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Comparison of Ambulatory, High-Dose, Intravenous Diuretic Therapy to Standard Hospitalization and Diuretic Therapy for Treatment of Acute Decompensated Heart Failure

Cited by 16 publications

References 18 publications

Remote monitoring for heart failure: Assessing the risks of readmission and mortality

Remote monitoring for heart failure: Assessing the risks of readmission and mortality

Unusually favorable course of chronic heart failure in patient with dilatative cardiomyopathy and very low left ventricular ejection fraction during three and a half year folow-up

Outpatient treatment of decompensated heart failure: A systematic review and study level meta‐analysis

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