Practical outpatient management of worsening chronic heart failure
Girerd, Nicolas (Université de Lorraine)
Mewton, Nathan (University Claude Bernard Lyon)
Tartière, Jean-Michel (Hôpital Sainte-Musse)
Guijarro, Damien (Université de Nantes)
Jourdain, Patrick (Assistance Publique-Hôpitaux de Paris)
Damy, Thibaud (CHU d'Henri-Mondor)
Lamblin, Nicolas (Université de Lille)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pellicori, Pierpaolo (University of Glasgow)
Januzzi, James L. (Harvard Medical School)
Rossignol, Patrick (Université de Lorraine)
Roubille, François (CHU de Montpellier)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Management of worsening heart failure (WHF) has traditionally been hospital-based, but with the rising burden of heart failure (HF), the pressure on healthcare 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 centres in the past 10 years, whereas European centres have been mostly favouring '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 IV diuretic administration are specifically emphasized. The algorithm provided along with the practical IV diuretic protocols should assist HF clinicians in implementing this new approach in their local clinical setting.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Ambulatory management ; Cardiac congestion ; Cardiovascular diseases ; Diuretics ; Heart failure
Publicado en:	European Journal of Heart Failure, Vol. 24 (april 2022) , p. 750-761, ISSN 1879-0844

DOI: 10.1002/ejhf.2503
PMID: 35417093

12 p, 16.7 MB

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