OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST)
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. In a single center, pros...
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| Veröffentlicht in: | PloS one 2021-06, Vol.16 (6), p.e0253014-e0253014 |
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| creator | Hamo, Carine E Abdelmoneim, Sahar S Han, Seol Young Chandy, Elizabeth Muntean, Cornelia Khan, Saadat A Sunkesula, Prasanthi Meykler, Marcella Ramachandran, Vidhya Rosenberg, Emelie Klem, Igor Sacchi, Terrence J Heitner, John F |
| description | 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. 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. 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. 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. |
| doi_str_mv | 10.1371/journal.pone.0253014 |
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The current study aimed to investigate the feasibility, safety, and efficacy of outpatient furosemide intravenous (IV) infusion following hospitalization for ADHF. 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. 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. 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0253014</identifier><identifier>PMID: 34170908</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Angioplasty ; Biology and Life Sciences ; Cardiology ; Care and treatment ; Complications and side effects ; Congestive heart failure ; Creatinine ; Diuretics ; Dosage ; Dyspnea ; Echocardiography ; Education ; Ejection fraction ; Furosemide ; Heart failure ; Hemodynamics ; Hospitalization ; Intravenous administration ; Laboratories ; Medicine and Health Sciences ; Mental depression ; Morbidity ; Patient outcomes ; Patients ; Pharmacists ; Placebos ; Quality of life ; Research and Analysis Methods ; Weight loss</subject><ispartof>PloS one, 2021-06, Vol.16 (6), p.e0253014-e0253014</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Hamo et al. 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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.</description><subject>Angioplasty</subject><subject>Biology and Life Sciences</subject><subject>Cardiology</subject><subject>Care and treatment</subject><subject>Complications and side effects</subject><subject>Congestive heart failure</subject><subject>Creatinine</subject><subject>Diuretics</subject><subject>Dosage</subject><subject>Dyspnea</subject><subject>Echocardiography</subject><subject>Education</subject><subject>Ejection fraction</subject><subject>Furosemide</subject><subject>Heart failure</subject><subject>Hemodynamics</subject><subject>Hospitalization</subject><subject>Intravenous administration</subject><subject>Laboratories</subject><subject>Medicine and Health Sciences</subject><subject>Mental depression</subject><subject>Morbidity</subject><subject>Patient 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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. 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.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34170908</pmid><doi>10.1371/journal.pone.0253014</doi><tpages>e0253014</tpages><orcidid>https://orcid.org/0000-0002-6011-0899</orcidid><orcidid>https://orcid.org/0000-0002-7063-1727</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2021-06, Vol.16 (6), p.e0253014-e0253014 |
| issn | 1932-6203 1932-6203 |
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| source | Public Library of Science (PLoS) Journals Open Access; PubMed (Medline); DOAJ Directory of Open Access Journals; Free Full-Text Journals in Chemistry; EZB Electronic Journals Library |
| subjects | Angioplasty Biology and Life Sciences Cardiology Care and treatment Complications and side effects Congestive heart failure Creatinine Diuretics Dosage Dyspnea Echocardiography Education Ejection fraction Furosemide Heart failure Hemodynamics Hospitalization Intravenous administration Laboratories Medicine and Health Sciences Mental depression Morbidity Patient outcomes Patients Pharmacists Placebos Quality of life Research and Analysis Methods Weight loss |
| title | OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST) |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-14T18%3A49%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=OUTpatient%20intravenous%20LASix%20Trial%20in%20reducing%20hospitalization%20for%20acute%20decompensated%20heart%20failure%20(OUTLAST)&rft.jtitle=PloS%20one&rft.au=Hamo,%20Carine%20E&rft.date=2021-06-25&rft.volume=16&rft.issue=6&rft.spage=e0253014&rft.epage=e0253014&rft.pages=e0253014-e0253014&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0253014&rft_dat=%3Cgale_plos_%3EA666439602%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2545226358&rft_id=info:pmid/34170908&rft_galeid=A666439602&rft_doaj_id=oai_doaj_org_article_a7155278062741abb30edd606c7a0dc4&rfr_iscdi=true |