Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (11)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Howard, P. A.
Right arrow Articles by Dunn, M. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Howard, P. A.
Right arrow Articles by Dunn, M. I.
(Chest. 2001;119:807-810.)
© 2001 American College of Chest Physicians

Aggressive Diuresis for Severe Heart Failure in the Elderly*

Patricia A. Howard, PharmD, BCPS, FCCP and Marvin I. Dunn, MD, Master FCCP

* From the Department of Pharmacy (Dr. Howard) and Division of Cardiovascular Medicine (Dr. Dunn), University of Kansas Medical Center, Kansas City, KS.

Correspondence to: Patricia A. Howard, PharmD, BCPS, FCCP, Department of Pharmacy, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160-7231

Study objective: To determine the efficacy, safety, and economic benefit of continuous IV infusion of furosemide as a treatment modality for elderly patients with class IV heart failure.

Design: Prospective trial of consecutively admitted elderly patients > 65 years old with class IV heart failure.

Setting: A single cardiovascular service in a university medical center.

Patients: Seventeen male and female patients > 65 years old consecutively admitted to a cardiovascular service.

Results: High-dose, continuous IV infusion of furosemide was successful in providing a 9- to 20-L diuresis in an average of 3.5 days without causing clinical complications or aberrations in blood chemistry. The length of stay was 2.3 days shorter than a contemporary group of class III and class IV elderly patients with heart failure managed on other medical services. The Medicare reimbursement for heart failure was $6,047. Patients receiving IV bolus diuretic therapy incurred billing charges of $10,193, or a loss of $4,146 per patient to the hospital. Patients receiving diuretic infusion therapy incurred billing charges of $4,944. This was a difference of $5,249 per patient treated by continuous IV infusion compared to bolus therapy and a profit per Medicare patient of $1,103. Therefore, a $4,146 billing loss was converted to $1,103 profit.

Conclusion: IV furosemide infusion therapy for class IV heart failure in the elderly is a safe, effective, and economic mode of therapy.

Key Words: congestive heart failure • economic saving • IV furosemide infusion






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American College of Chest Physicians.