Ryder Mary, Murphy Niamh F, McCaffrey Dermot, O'Loughlin Christina, Ledwidge Mark, McDonald Kenneth
Heart Failure Unit, Department of Cardiology, St Vincent's University Hospital, Dublin, Ireland.
Eur J Heart Fail. 2008 Mar;10(3):267-72. doi: 10.1016/j.ejheart.2008.01.003. Epub 2008 Mar 4.
Heart failure patients have frequent readmissions for acute decompensated heart failure (ADHF).
To examine the feasibility, safety and outcomes of outpatient intravenous (IV) diuretic therapy in treating ADHF.
A retrospective analysis was performed of all patients included in a hospital-based heart failure disease management programme, who received outpatient IV diuretic therapy for the management of ADHF between 2002 and 2006. Changes in clinical and biochemical parameters from time of therapy to stability were measured.
One hundred and seven patients (mean age 71+/-11 years) received outpatient IV diuretic therapy for ADHF IV diuretic administration reduced weight (p<0.001), blood pressure (p<0.01) and BNP (p=0.01). It increased urea (p=0.01) and creatinine (p=0.07). Seventy-two percent of patients stabilised following IV diuretics and did not require admission. No patients were hospitalised for hypotension or hypokalaemia. One patient was hospitalised for renal failure. Two patients died post admission.
Outpatient IV diuretic administration for ADHF is safe, cost effective and reduces hospitalisations. This service may expand the potential of a disease management programme to manage ADHF out of hospital and thereby reduce the hospital dependency of this condition.
心力衰竭患者因急性失代偿性心力衰竭（ADHF）频繁再次入院。
探讨门诊静脉利尿剂治疗ADHF的可行性、安全性及疗效。
对纳入一项基于医院的心力衰竭疾病管理项目的所有患者进行回顾性分析，这些患者在2002年至2006年间接受门诊静脉利尿剂治疗以管理ADHF。测量从治疗开始到病情稳定时临床和生化参数的变化。
107例患者（平均年龄71±11岁）接受门诊静脉利尿剂治疗ADHF。静脉利尿剂给药使体重降低（p<0.001）、血压降低（p<0.01）和脑钠肽降低（p=0.01）。它使尿素升高（p=0.01）和肌酐升高（p=0.07）。72%的患者在静脉使用利尿剂后病情稳定，无需住院。没有患者因低血压或低钾血症住院。1例患者因肾衰竭住院。2例患者入院后死亡。
门诊静脉给予利尿剂治疗ADHF安全、具有成本效益且可减少住院次数。这项服务可能会扩大疾病管理项目在院外管理ADHF的潜力，从而减少这种疾病对医院的依赖。
