PMID- 10909705
OWN - NLM
STAT- MEDLINE
DCOM- 20000920
LR  - 20071115
IS  - 0738-0658 (Print)
IS  - 0738-0658 (Linking)
VI  - 19
IP  - 2
DP  - 2000 Jun
TI  - Intermittent infusion of inotropes in the outpatient setting: one-year post 
      treatment analysis.
PG  - 107-14
AB  - The course of patients with New York Heart Association (NYHA) class III and IV 
      and refractory heart failure symptoms is characterized by progressive clinical 
      deterioration and frequent hospital readmissions. The value of intermittent 
      intravenous administration of inotropes in managing this group of patients in the 
      outpatient setting has been controversial. In this study, patients with 
      refractory heart failure symptoms were enrolled to assess the impact of a 
      multidisciplinary outpatient program in terms of on hospital admissions, 
      emergency room visits, and interval free of symptoms after administration of 
      inotropes. This is a retrospective analysis on 41 patients with refractory heart 
      failure treated at our outpatient cardiac infusion unit over a 20 month period. 
      Thirteen patients with a NYHA class III [age 64 +/- 13; LVEF 27 +/- 9%] and 28 
      patients with a NYHA class IV [age 65 +/- 13 years; LVEF 21 +/- 9%], mostly 
      males, were included. A total of 65 admissions for decompensated HF were recorded 
      in the previous 6-months prior to initiation of the outpatient program; compared 
      to only 4 emergency room visits and 7 hospital admissions after enrollment. 
      Furthermore, 17 patients have been discharged with improvement in NYHA class from 
      3.5 +/- 0.6 to 1.4 +/- 0.5. On these patients, the interval free of symptoms 
      since the last infusion treatment has ranged from 201 to 489 days, without 
      emergency room visits or hospital admissions for congestive heart failure. The 
      results of this study support the use of intermittent infusion of inotropes in 
      the outpatient setting. Although the natural history for patients with refractory 
      heart failure has been grim; the use of these intermittent infusions may in fact 
      alter the natural course of end stage congestive heart failure patients and 
      deserves further investigation.
FAU - Lopez-Candales, A
AU  - Lopez-Candales A
AD  - Division of Cardiology, Buffalo General Hospital, State University of New York, 
      New York 14203, USA.
FAU - Carron, C
AU  - Carron C
FAU - Graham, S
AU  - Graham S
FAU - Schwartz, J
AU  - Schwartz J
LA  - eng
PT  - Journal Article
PL  - Puerto Rico
TA  - P R Health Sci J
JT  - Puerto Rico health sciences journal
JID - 8303541
RN  - 0 (Cardiotonic Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Ambulatory Care
MH  - Cardiotonic Agents/*administration & dosage
MH  - Emergencies
MH  - Female
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Remission Induction
MH  - Severity of Illness Index
MH  - Time Factors
EDAT- 2000/07/26 11:00
MHDA- 2000/09/23 11:01
CRDT- 2000/07/26 11:00
PHST- 2000/07/26 11:00 [pubmed]
PHST- 2000/09/23 11:01 [medline]
PHST- 2000/07/26 11:00 [entrez]
PST - ppublish
SO  - P R Health Sci J. 2000 Jun;19(2):107-14.