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Furosemide in end-stage heart failure: community subcutaneous infusions.
Brown, Andrew; Westley, Katharine; Robson, Judith; Armstrong, Leonie; Matthews, Iain; Runnett, Craig; Ripley, David; Thomas, Honey.
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  • Brown A; Cardiology Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
  • Westley K; Cardiology Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
  • Robson J; Cardiology Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
  • Armstrong L; Cardiology Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
  • Matthews I; Cardiology Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
  • Runnett C; Cardiology Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
  • Ripley D; Cardiology Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
  • Thomas H; Cardiology Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK Honey.Thomas@northumbria-healthcare.nhs.uk.
BMJ Support Palliat Care ; 12(e6): e763-e766, 2022 Dec.
Article en En | MEDLINE | ID: mdl-32647034
BACKGROUND: In chronic heart failure many patients have recurrent hospital admissions and it is the leading cause of admission in people aged over 65 years. In those with end-stage heart failure, there is limited evidence that furosemide can be given subcutaneously to relieve symptoms and avoid hospital admission. METHOD: We initiated a community-based continuous subcutaneous infusion (CSCI) furosemide service for the treatment of advanced heart failure. We aimed to increase patient choice, offer an alternative to hospital admission and, in patients at the end of their life, allow them to die at their preferred place of care with symptom alleviation. We retrospectively reviewed case notes. RESULTS: 36 consecutive episodes of CSCI of treatment were recorded in 28 patients. 15 patients (54%) survived beyond the initial treatment course with 13 patients (87%) avoiding acute hospital admission. There was a reduction in mean hospital admission rates from 2.87 to 0.73 (p<0.001) in the 6-month periods either side of the first episode of CSCI furosemide. A median reduction of 4 kg weight loss was recorded. 13 patients died during the initial treatment course. 12 (92%) died at home and 1 died at the hospital palliative care unit. All had symptoms controlled. CONCLUSION: Subcutaneous furosemide can be successfully delivered in the community. In addition to palliation in the final days of life, community subcutaneous furosemide can be an effective treatment leading to weight loss and improved symptoms with survival for several months.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Furosemida / Insuficiencia Cardíaca Tipo de estudio: Observational_studies / Prognostic_studies Límite: Aged / Humans Idioma: En Revista: BMJ Support Palliat Care Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Furosemida / Insuficiencia Cardíaca Tipo de estudio: Observational_studies / Prognostic_studies Límite: Aged / Humans Idioma: En Revista: BMJ Support Palliat Care Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido