Creative solutions: home dobutamine infusions

The increase in the number of congestive heart failure patient hospitalizations each year poses a challenge to the nurses caring for this population. Numerous alternatives to hospital care must be explored. The use of dobutamine infusions in the home is a particular challenge. In this article, the pathophysiology and signs and symptoms of congestive heart failure are summarized. In addition, the pharmacology, clinical effects, and side effects of dobutamine are addressed. Recommendations are suggested for selection of patients for home therapy, dosage, administration, and monitoring parameters for follow-up. Finally, therapeutic endpoints are discussed, as well as financial benefits of home dobutamine infusion.