OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).

<h4>Background</h4>Hospitalization for acute decompensated heart failure (ADHF) remains a major source of morbidity and mortality. The current study aimed to investigate the feasibility, safety, and efficacy of outpatient furosemide intravenous (IV) infusion following hospitalization for...

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Autores principales:	Carine E Hamo, Sahar S Abdelmoneim, Seol Young Han, Elizabeth Chandy, Cornelia Muntean, Saadat A Khan, Prasanthi Sunkesula, Marcella Meykler, Vidhya Ramachandran, Emelie Rosenberg, Igor Klem, Terrence J Sacchi, John F Heitner
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a7155278062741abb30edd606c7a0dc4
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spelling	oai:doaj.org-article:a7155278062741abb30edd606c7a0dc42021-12-02T20:15:47ZOUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).1932-620310.1371/journal.pone.0253014https://doaj.org/article/a7155278062741abb30edd606c7a0dc42021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253014https://doaj.org/toc/1932-6203<h4>Background</h4>Hospitalization for acute decompensated heart failure (ADHF) remains a major source of morbidity and mortality. The current study aimed to investigate the feasibility, safety, and efficacy of outpatient furosemide intravenous (IV) infusion following hospitalization for ADHF.<h4>Methods</h4>In a single center, prospective, randomized, double-blind study, 100 patients were randomized to receive standard of care (Group 1), IV placebo infusion (Group 2), or IV furosemide infusion (Group 3) over 3h, biweekly for a one-month period following ADHF hospitalization. Patients in Groups 2/3 also received a comprehensive HF-care protocol including bi-weekly clinic visits for dose-adjusted IV-diuretics, medication adjustment and education. Echocardiography, quality of life and depression questionnaires were performed at baseline and 30-day follow-up. The primary outcome was 30-day re-hospitalization for ADHF.<h4>Results</h4>Overall, a total of 94 patients were included in the study (mean age 64 years, 56% males, 69% African American). There were a total of 14 (15%) hospitalizations for ADHF at 30 days, 6 (17.1%) in Group 1, 7 (22.6%) in Group 2, and 1 (3.7%) in Group 3 (overall p = 0.11; p = 0.037 comparing Groups 2 and 3). Patients receiving IV furosemide infusion experienced significantly greater urine output and weight loss compared to those receiving placebo without any significant increase creatinine and no significant between group differences in echocardiography parameters, KCCQ or depression scores.<h4>Conclusion</h4>The use of a standardized protocol of outpatient IV furosemide infusion for a one-month period following hospitalization for ADHF was found to be safe and efficacious in reducing 30-day re-hospitalization.Carine E HamoSahar S AbdelmoneimSeol Young HanElizabeth ChandyCornelia MunteanSaadat A KhanPrasanthi SunkesulaMarcella MeyklerVidhya RamachandranEmelie RosenbergIgor KlemTerrence J SacchiJohn F HeitnerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253014 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Carine E Hamo Sahar S Abdelmoneim Seol Young Han Elizabeth Chandy Cornelia Muntean Saadat A Khan Prasanthi Sunkesula Marcella Meykler Vidhya Ramachandran Emelie Rosenberg Igor Klem Terrence J Sacchi John F Heitner OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).
description	<h4>Background</h4>Hospitalization for acute decompensated heart failure (ADHF) remains a major source of morbidity and mortality. The current study aimed to investigate the feasibility, safety, and efficacy of outpatient furosemide intravenous (IV) infusion following hospitalization for ADHF.<h4>Methods</h4>In a single center, prospective, randomized, double-blind study, 100 patients were randomized to receive standard of care (Group 1), IV placebo infusion (Group 2), or IV furosemide infusion (Group 3) over 3h, biweekly for a one-month period following ADHF hospitalization. Patients in Groups 2/3 also received a comprehensive HF-care protocol including bi-weekly clinic visits for dose-adjusted IV-diuretics, medication adjustment and education. Echocardiography, quality of life and depression questionnaires were performed at baseline and 30-day follow-up. The primary outcome was 30-day re-hospitalization for ADHF.<h4>Results</h4>Overall, a total of 94 patients were included in the study (mean age 64 years, 56% males, 69% African American). There were a total of 14 (15%) hospitalizations for ADHF at 30 days, 6 (17.1%) in Group 1, 7 (22.6%) in Group 2, and 1 (3.7%) in Group 3 (overall p = 0.11; p = 0.037 comparing Groups 2 and 3). Patients receiving IV furosemide infusion experienced significantly greater urine output and weight loss compared to those receiving placebo without any significant increase creatinine and no significant between group differences in echocardiography parameters, KCCQ or depression scores.<h4>Conclusion</h4>The use of a standardized protocol of outpatient IV furosemide infusion for a one-month period following hospitalization for ADHF was found to be safe and efficacious in reducing 30-day re-hospitalization.
format	article
author	Carine E Hamo Sahar S Abdelmoneim Seol Young Han Elizabeth Chandy Cornelia Muntean Saadat A Khan Prasanthi Sunkesula Marcella Meykler Vidhya Ramachandran Emelie Rosenberg Igor Klem Terrence J Sacchi John F Heitner
author_facet	Carine E Hamo Sahar S Abdelmoneim Seol Young Han Elizabeth Chandy Cornelia Muntean Saadat A Khan Prasanthi Sunkesula Marcella Meykler Vidhya Ramachandran Emelie Rosenberg Igor Klem Terrence J Sacchi John F Heitner
author_sort	Carine E Hamo
title	OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).
title_short	OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).
title_full	OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).
title_fullStr	OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).
title_full_unstemmed	OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).
title_sort	outpatient intravenous lasix trial in reducing hospitalization for acute decompensated heart failure (outlast).
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/a7155278062741abb30edd606c7a0dc4
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OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).

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