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Published on: July 28, 2018
Aggressive diuresis for severe heart failure in the elderly
1Department of Pharmacy, University of Kansas Medical Center, Kansas City, KS 66160-7231, USA.
Chest
|March 13, 2001
Summary
Continuous intravenous infusion of furosemide effectively treats elderly heart failure patients, improving outcomes and reducing hospital costs. This safe and economical therapy offers significant financial benefits compared to traditional bolus methods.
Area of Science:
- Cardiology
- Pharmacology
- Geriatrics
Background:
- Elderly patients with advanced heart failure (Class IV) often require intensive management.
- Diuretic therapy is a cornerstone in managing fluid overload associated with heart failure.
Purpose of the Study:
- To evaluate the efficacy, safety, and economic impact of continuous intravenous (IV) furosemide infusion in elderly patients with Class IV heart failure.
- To compare the economic benefits of continuous IV furosemide infusion versus IV bolus administration.
Main Methods:
- Prospective trial involving elderly patients (over 65) admitted with Class IV heart failure.
- Treatment involved high-dose, continuous IV infusion of furosemide.
- Outcomes measured included diuresis, clinical complications, blood chemistry, length of stay, and financial reimbursement.
Main Results:
- Continuous IV furosemide achieved significant diuresis (9-20 L) in an average of 3.5 days without adverse clinical events or lab abnormalities.
- This therapy shortened hospital stays by 2.3 days compared to contemporary groups.
- Continuous infusion resulted in a profit of $1,103 per Medicare patient, converting an average loss of $4,146 associated with bolus therapy.
Conclusions:
- Continuous IV furosemide infusion is a safe and effective treatment for elderly patients with Class IV heart failure.
- This therapeutic approach offers significant economic advantages, improving hospital finances.
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