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Current Heart Failure Reports

Erschienen in:

24.08.2020 | Ethics/Palliative Care (S Fedson, Section Editor)

Home Therapies in Advanced Heart Failure: Inotropes and Diuretics

verfasst von: Jason P. Graffagnino, Leslie C. Avant, Bethany C. Calkins, Keith M. Swetz

Erschienen in: Current Heart Failure Reports | Ausgabe 5/2020

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Abstract

Purpose of Review

Heart failure (HF) is a significant cause of morbidity, mortality, and decreased quality of life (QOL). Symptoms, including reduced activity tolerance, fatigue, palpitations, and dyspnea, result from volume overload or low output states. Herein, we review the best available literature supporting diuretic and inotropic therapies in advanced HF and how these improve QOL.

Recent Findings

While diuretics and inotropes reduce symptoms and hospitalizations in advanced HF, there is an increased risk of harms with both modalities. While diuretic complications include electrolyte and renal function abnormalities, adverse event data with inotropes is more complex and includes possible arrhythmias and death. Further, inotrope utilization is complicated by required intravenous access, infusion costs, and limited outpatient support.

Summary

Ambulatory use of diuretics and inotropes may improve patients’ QOL through symptom management and reduced hospitalizations. However, risks and limitations of both modalities must be considered as treatment decisions are made.

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Titel: Home Therapies in Advanced Heart Failure: Inotropes and Diuretics
verfasst von: Jason P. Graffagnino
Leslie C. Avant
Bethany C. Calkins
Keith M. Swetz
Publikationsdatum: 24.08.2020
Verlag: Springer US
Erschienen in: Current Heart Failure Reports / Ausgabe 5/2020
Print ISSN: 1546-9530
Elektronische ISSN: 1546-9549
DOI: https://doi.org/10.1007/s11897-020-00482-y

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Home Therapies in Advanced Heart Failure: Inotropes and Diuretics