[Infusion of inotropic agents at home in patients with severe heart failure: an important role for the nurse practitioner].
Patients with severe heart failure commonly require intravenous inotropic agents to stabilise their haemodynamics and improve the clinical symptoms. Continuous intravenous inotropic agents in a home-based setting under the direction of specialised nurses has been introduced in patients waiting for cardiac transplantation and also as destination therapy. Since 1982, several case reports and case series have described the use of ambulatory intravenous dobutamine, but almost none of the available studies included a control group. Moreover, most trials were small and short in duration, and thus have not been able to provide reliable information about the effect of treatment on the risk of serious cardiac events. However, these data consistently demonstrate the feasibility of home infusion as well as an improved quality of life and reduced costs. Therefore, home infusion of dobutamine guided by a specialised nurse may be desirable in patients waiting for heart transplantation or as destination therapy in the last weeks of life.
Leids Universitair Medisch Centrum, Afd. Cardiologie C5-P, Postbus 9600, 2300 RC Leiden.
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Ypenburg
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Verwey
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van der Wall
D000553:Ambulatory Care / Q000379:methods*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004280:Dobutamine / Q000627:therapeutic use; D017048:Health Care Costs; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics / Q000451:nursing; D018718:Home Infusion Therapy / Q000191:economics; D006801:Humans; D009729:Nursing / Q000379:methods*; D011788:Quality of Life
D002316:Cardiotonic Agents; D004280:Dobutamine