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Related Concept Videos

Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

345
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
345
Mitral Regurgitation IV: Nursing Management01:28

Mitral Regurgitation IV: Nursing Management

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Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
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Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Dialysis01:27

Dialysis

269
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
269
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

391
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
391

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Related Experiment Video

Updated: Jun 8, 2025

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
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Managing an Advanced Heart Failure Patient at Home With a Long-Term Continuous Intravenous Furosemide Infusion.

Julie G Chirnside1, Catherine J Malone1, Joanne G Scott1

  • 1Cardio-respiratory Integrated Specialist Services, Te Whatu Ora Health NZ, Christchurch, New Zealand.

JACC. Case Reports
|November 1, 2024
PubMed
Summary

Continuous home intravenous furosemide infusions effectively manage persistent congestion in advanced heart failure patients. Elastomeric pumps offer a safe, simple method for home diuretic therapy when coordinated by heart failure nurses.

Keywords:
cost-savingsdiureticsfurosemideheart failurehomeinfusionintravenousnursingpalliativequality of life

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Area of Science:

  • Cardiology
  • Pharmacology
  • Home Healthcare

Background:

  • Advanced heart failure often presents with persistent congestion, requiring effective management strategies.
  • Intravenous furosemide is a key diuretic, but home administration can be challenging.

Observation:

  • A simple therapeutic intervention using continuous intravenous furosemide infusion via a non-powered elastomeric pump was implemented in the home setting.
  • Patients selected were known responders to intravenous furosemide with a supportive home environment.
  • Inpatient initiation was used to test feasibility and determine intravenous access, with robust communication links established between all care providers and the patient.

Findings:

  • Continuous high-dose intravenous furosemide infusion can be safely managed in the home for persistent congestion in chronic heart failure.
  • Elastomeric pumps provide a simple, safe, and effective method for delivering intravenous diuretic therapy.
  • Community nursing support was crucial for initial pump management, line maintenance, and patient education on self-management.

Implications:

  • This approach enables effective management of diuretic therapy in the home setting, potentially reducing hospital readmissions.
  • Elastomeric pump delivery simplifies continuous intravenous diuretic administration for heart failure patients.
  • Coordinated care involving heart failure nurses and community support is vital for successful home-based intravenous therapy.