Infusion of inotropic agents at home in patients with severe heart failure: an important role for the nurse practitioner
Ypenburg, C.; Verwey, H.F.; van der Wall, E.E.
Nederlands Tijdschrift Voor Geneeskunde 151(44): 2426-2428
2007
ISSN/ISBN: 0028-2162 PMID: 18064859 Document Number: 609375
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.