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The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series

We present a case series of seven patients with an established diagnosis of heart failure enrolled in a transitional care program that were treated with intravenous diuretic therapy in the outpatient setting. The patients presented in this cases series were treated due to the development of decompen...

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Autores principales: Lazkani, Mohamad, Ota, Ken S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513427/
https://www.ncbi.nlm.nih.gov/pubmed/23226178
http://dx.doi.org/10.4021/jocmr1106w
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author Lazkani, Mohamad
Ota, Ken S.
author_facet Lazkani, Mohamad
Ota, Ken S.
author_sort Lazkani, Mohamad
collection PubMed
description We present a case series of seven patients with an established diagnosis of heart failure enrolled in a transitional care program that were treated with intravenous diuretic therapy in the outpatient setting. The patients presented in this cases series were treated due to the development of decompensated heart failure within 30 days of their discharge from our hospital. All seven patients stated that they would have originally presented to the emergency department for their symptoms, but consented to alternative treatment by a transitional care physician, or transitionalist. These patients with decompensated heart failure (four male and three female) with a median age of 55 years (24 - 84 years) were evaluated and treated from November 2011 to March 2012. Of the seven patients, four presented with decompensated systolic heart failure (three with diastolic). All seven patients were treated with an intravenous diuretic for hypervolemia in our outpatient infusion room. All of the patients experienced relief of their dyspnea the day of diuretic administration or the following day. No adverse effects or emergency department transfers occurred as a result of outpatient intravenous diuretic therapy. Through the use of outpatient intravenous diuretic therapy, we have avoided the need for emergency department visits and potential hospitalization in select patients with decompensated heart failure. Based on our preliminary findings, the clinical efficacy of this approach to the treatment of heart failure decompensation is not only due to the pharmacologic effectiveness of intravenous diuretics, but also due to the bidirectional open line of communication that exists between transitionalist and patients in the program. The direct telephone access that patients have to the transitionalist allows for close post-hospitalization monitoring and facilitates timely evaluation and treatment when acute issues arise. The added benefit of our particular transitional care program is that we have an alternate venue in the hospital where our transitional care patients can be treated for heart failure decompensation (our outpatient infusion room), thus, enabling us to avoid emergency department transfers and possible hospital admissions. Further investigation of this therapy in a non-emergency department setting is warranted as our experience with this treatment modality is limited to the case series presented.
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spelling pubmed-35134272012-12-05 The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series Lazkani, Mohamad Ota, Ken S. J Clin Med Res Case Report We present a case series of seven patients with an established diagnosis of heart failure enrolled in a transitional care program that were treated with intravenous diuretic therapy in the outpatient setting. The patients presented in this cases series were treated due to the development of decompensated heart failure within 30 days of their discharge from our hospital. All seven patients stated that they would have originally presented to the emergency department for their symptoms, but consented to alternative treatment by a transitional care physician, or transitionalist. These patients with decompensated heart failure (four male and three female) with a median age of 55 years (24 - 84 years) were evaluated and treated from November 2011 to March 2012. Of the seven patients, four presented with decompensated systolic heart failure (three with diastolic). All seven patients were treated with an intravenous diuretic for hypervolemia in our outpatient infusion room. All of the patients experienced relief of their dyspnea the day of diuretic administration or the following day. No adverse effects or emergency department transfers occurred as a result of outpatient intravenous diuretic therapy. Through the use of outpatient intravenous diuretic therapy, we have avoided the need for emergency department visits and potential hospitalization in select patients with decompensated heart failure. Based on our preliminary findings, the clinical efficacy of this approach to the treatment of heart failure decompensation is not only due to the pharmacologic effectiveness of intravenous diuretics, but also due to the bidirectional open line of communication that exists between transitionalist and patients in the program. The direct telephone access that patients have to the transitionalist allows for close post-hospitalization monitoring and facilitates timely evaluation and treatment when acute issues arise. The added benefit of our particular transitional care program is that we have an alternate venue in the hospital where our transitional care patients can be treated for heart failure decompensation (our outpatient infusion room), thus, enabling us to avoid emergency department transfers and possible hospital admissions. Further investigation of this therapy in a non-emergency department setting is warranted as our experience with this treatment modality is limited to the case series presented. Elmer Press 2012-12 2012-11-11 /pmc/articles/PMC3513427/ /pubmed/23226178 http://dx.doi.org/10.4021/jocmr1106w Text en Copyright 2012, Lazkani et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Lazkani, Mohamad
Ota, Ken S.
The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series
title The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series
title_full The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series
title_fullStr The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series
title_full_unstemmed The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series
title_short The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series
title_sort role of outpatient intravenous diuretic therapy in a transitional care program for patients with heart failure: a case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513427/
https://www.ncbi.nlm.nih.gov/pubmed/23226178
http://dx.doi.org/10.4021/jocmr1106w
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