PMID- 8831370
OWN - NLM
STAT- MEDLINE
DCOM- 19961101
LR  - 20190626
IS  - 0002-8703 (Print)
IS  - 0002-8703 (Linking)
VI  - 132
IP  - 4
DP  - 1996 Oct
TI  - Intermittent inotropic therapy in an outpatient setting: a cost-effective 
      therapeutic modality in patients with refractory heart failure.
PG  - 805-8
AB  - Patients with intractable heart failure (New York Heart Association [NYHA] class 
      III and IV) who were receiving maximal conventional treatment were enrolled in an 
      outpatient program that included inotropic infusions, intensive patient 
      education, and close follow-up. The effects of this approach to therapy were 
      evaluated on (1) the number of hospital admissions, (2) length of stay, and (3) 
      number of emergency room visits during the ensuing year. These data were compared 
      with similar data from the year before entry in the program for each patient. 
      Thirty-six patients with stable NYHA class III and IV heart failure received 
      milrinone or dobutamine to manage chronic heart failure in an outpatient setting. 
      The cause of heart failure was ischemic heart disease in 12, idiopathic in 11, 
      hypertension in 8, and pulmonary hypertension in 5. Four patients received 
      dobutamine and 32 patients received milrinone. The mean period of observation was 
      294 days. For the period before entry in the program, patients had 21 emergency 
      room visits, 75 admissions, and 528 days spent in the hospital. After enrollment, 
      patients had 10 emergency room visits, 34 admissions, and 150 days spent in the 
      hospital. In conclusion, this therapeutic regimen reduced the number of hospital 
      admissions, days spent in the hospital, and emergency room visits. Our study 
      supports the concept that the use of intermittent inotropic therapy in the 
      outpatient setting plays an important role in managing this severely ill group of 
      patients.
FAU - Marius-Nunez, A L
AU  - Marius-Nunez AL
AD  - Division of Cardiology, Michael Reese Hospital and Medical Center, Chicago, IL 
      60616, USA.
FAU - Heaney, L
AU  - Heaney L
FAU - Fernandez, R N
AU  - Fernandez RN
FAU - Clark, W A
AU  - Clark WA
FAU - Ranganini, A
AU  - Ranganini A
FAU - Silber, E
AU  - Silber E
FAU - Denes, P
AU  - Denes P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Pyridones)
RN  - 3S12J47372 (Dobutamine)
RN  - JU9YAX04C7 (Milrinone)
RN  - JUT23379TN (Amrinone)
SB  - IM
MH  - *Ambulatory Care
MH  - Amrinone/administration & dosage/therapeutic use
MH  - Cardiotonic Agents/*administration & dosage/therapeutic use
MH  - Cost-Benefit Analysis
MH  - Dobutamine/*administration & dosage/therapeutic use
MH  - Drug Administration Schedule
MH  - Emergency Service, Hospital/statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*drug therapy/economics
MH  - Humans
MH  - Infusions, Intravenous
MH  - Length of Stay/economics/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Milrinone
MH  - Patient Admission/economics/statistics & numerical data
MH  - Patient Education as Topic
MH  - Pyridones/*administration & dosage/therapeutic use
MH  - Time Factors
EDAT- 1996/10/01 00:00
MHDA- 1996/10/01 00:01
CRDT- 1996/10/01 00:00
PHST- 1996/10/01 00:00 [pubmed]
PHST- 1996/10/01 00:01 [medline]
PHST- 1996/10/01 00:00 [entrez]
AID - S0002-8703(96)90315-4 [pii]
AID - 10.1016/s0002-8703(96)90315-4 [doi]
PST - ppublish
SO  - Am Heart J. 1996 Oct;132(4):805-8. doi: 10.1016/s0002-8703(96)90315-4.