Practical outpatient management of worsening chronic heart failure

Girerd, N. et al. (2022) Practical outpatient management of worsening chronic heart failure. European Journal of Heart Failure, 24(5), pp. 750-761. (doi: 10.1002/ejhf.2503) (PMID:35417093)

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Abstract

Management of worsening heart failure (WHF) has traditionally been hospital-based, but with the rising burden of HF, the pressure on health care systems exerted by this disease necessitates a different strategy than long (and costly) hospital stays. A strategy for outpatient intravenous (IV) diuretic treatment of WHF has been developed in certain American centers in the past 10 years, whereas European centers have been mostly favoring “classic” in-hospital management of WHF. Embracing novel, outpatient approaches for treating WHF could substantially reduce the burden on healthcare systems while improving patient's satisfaction and quality of life. The present article is intended to provide essential knowledge and practical guidelines aimed at helping clinicians implement these new ambulatory approaches using day hospital and/or at-home hospitalization. The topics addressed by our group of HF experts include the pathophysiological background of diuretic therapy, the most suitable profile of WHF that may be managed in an ambulatory setting, the pharmacological protocols that can be used, as well as a detailed description of healthcare structures that can be proposed to deliver these ambulatory care interventions. The practical aspects of day hospital and Hospital-at-Home (HaH) IV diuretics administration are specifically emphasized. The algorithm provided along with the practical IV diuretics protocols should assist HF clinicians in implementing this new approach in their local clinical setting.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pellicori, Dr Pierpaolo
Authors: Girerd, N., Newton, N., Tartière, J.-M., Guijarro, D., Jourdain, P., Damy, T., Lamblin, N., Bayes-Génis, A., Pellicori, P., Januzzi, J., Rossignol, P., and Roubille, F.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
Journal Name:European Journal of Heart Failure
Publisher:Wiley
ISSN:1388-9842
ISSN (Online):1879-0844
Published Online:13 April 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in European Journal of Heart Failure 24(5): 750-761
Publisher Policy:Reproduced under a Creative Commons License

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