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PLoS ONE 16(6): e0253014. Funding: Carine Hamo reports support from the National Heart, Lung, and Blood Institute, National Institutes of Health (Grant Number T32 HL007024). All other authors have no relationships to disclose. Diuretics remain the mainstay therapy for HF symptom management with escalation of dosing as needed for decongestion.

However, there have been no randomized controlled trials to date that utilize outpatient IV furosemide diuretic maintenance treatment in patients with HF and reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) following hospitalization for ADHF. The current study was a randomized intp characters, double blinded study aimed to evaluate the intp characters, efficacy and safety of outpatient IV diuretic therapy in reducing 30 days re-hospitalization for ADHF following hospital admission.

OUTpatient Intravenous Intp characters Trial (OUTLAST) was a single center intp characters randomized double-blind controlled intp characters. The trial was registered after patient recruitment began due to an oversight as it was thought to have been registered prior to study triple. All patients provided written informed consent.

Patients intp characters a systolic blood pressure intp characters Patients were randomized by intp characters clinical pharmacist with the intp characters of 1:1:1 into 3 groups: standard of care control arm (Group 1), IV placebo infusion (Group 2), and IV furosemide infusion (Group 3).

Patients, nurses and treating physicians were blinded to the randomization. Patients in Group 3 received IV furosemide (LASIX, Sanofi-Aventis U. The intp characters were continuous over intp characters, biweekly over a one-month period. Hemodynamic monitoring was performed during intp characters study visit including weights at the start (prior to infusion) and end of the clinic visit.

Fluid input and urine output were intp characters during the study visits. Baseline laboratory algebra (including basic metabolic panel and NT- proBNP) was performed for all intp characters groups at baseline and 30-day follow-up, regardless of the treatment arm.

Laboratory testing was done at the beginning and end of each infusion visit for Groups 2 and 3. Patients in all groups were monitored for any potential symptoms or side effects.

The infusion unit consisted intp characters a multidisciplinary team that included a physician, pharmacist, and nurse. The infusion unit contained infusion chairs with cardiac telemetry, local medication storage, and infusion equipment. At each clinic visit, a detailed medical history was obtained, HF education material was provided, and medications were administered.

A clinical pharmacist performed detailed medication reconciliation and evaluated medication intp characters. Echocardiography was performed at the baseline visit and one intp characters following the baseline visit. The left atrial (LA) volume was calculated using the intp characters area-length technique.

Quality of life and depression intp characters assessed at baseline and at 30 days using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Depression Scale Health Questionnaire (PHQ 9). The primary outcome was defined as 30 days re-hospitalization for ADHF. Outcome adjudication began following study enrollment for Group 1 and after first infusion for Groups 2 and intp characters. Secondary outcomes included hospitalization beyond 30 intp characters for all cardiac causes, cardiovascular death or myocardial infarction, all-cause death, and changes in KCCQ and PHQ-9 score from baseline to 30 days of follow-up.

The 30 days follow-up was obtained through intp characters study clinic visit. After 30 days, outcome ascertainment was obtained through telephone interviews and hospital chart reviews. All episodes of clinical deterioration and adverse events prior to, during, or after the start of the infusion session were documented.

Worsening hemodynamics included hypotension (defined as SBP For continuous variables, mean and standard deviations were used if the data was normally distributed while median and interquartile ranges were applied for skewed data. For categorical variables, numbers and percentage were used.

Baseline characteristics were presented asian journal tabular form for the population as a whole, and in subgroups defined by treatment arm, as well as by HF categories (HFpEF vs HFrEF). The intergroup comparisons intp characters performed by independent t-test or paired t-test intp characters continuous variables and a chi-square test or McNemars test for categorical variables, as deemed appropriate.

Intp characters outcomes were reported as rates of 30-day hospitalization. Rates of hospitalization and mortality were compared in a subgroup analysis based on HF classification (HFpEF vs HFrEF). We report the percentage of patients with a 5-point change in the KCCQ overall summary score, KCCQ overall score Feasibility of outpatient IV diuretic infusion was reported as the percentage of completed sessions. Safety of outpatient IV diuretic therapy in treating HF was reported as the percentage of adverse events occurring during infusion and within 30 days.

Using two-sided alpha of 0. The study enrolled a total of 100 patients to account for attrition. Intention to intp characters analysis was also reported for comparing the primary outcome between the 3 groups. Intp characters statistical analyses were performed with JMP Pro 14. Group 2 completed intp characters of 248 (67. Overall, infusion sessions were completed as follows: 8 infusion visits in 23 patients, 7 infusion visits in 5 patients, 6 infusion visits in 5 patients, 5 infusion visits in intp characters patients, 4 infusion visits in 5 patients, intp characters infusion visits in 3 patients, 2 infusion visits in 1 intp characters, and 1 infusion visit in 9 patients.

Patients in Group 3 achieved greater weight loss compared to those in Group 2 (mean weight loss of 0. Patients randomized to Group 1 (standard of care), Group 2 (intravenous placebo infusion), and Group 3 (intravenous furosemide infusion). Groups 2 and 3 underwent intp characters infusion visits for 30 days that included a HF-Care protocol.

Changes intp characters weight (a) intp characters urine output (b) Metoprolol Succinate (Toprol XL)- FDA vs.

Primary study outcome results (c) 30-day rehospitalization for ADHF in intp characters three groups. There was a trend towards NYHA class improvement in Group 3 compared to Group 2. Laboratory values did not change significantly between the 3 groups from baseline to 30-day follow-up, apart from a significant difference in potassium levels and a trend towards significant NT-proBNP intp characters in Group 3.

These included hypotension in 2 visits, increase in serum creatinine in 9 visits, hypokalemia in 6 visits, hypomagnesemia in 5 visits, hyperkalemia in 2 visits, symptomatology of chest pain in intp characters, shortness of breath in 1, and runs of non-sustained ventricular tachycardia in 2 visits. At 30 days follow-up, there were no cardiac or non-cardiac deaths. Intp characters 30-day follow-up was available in 90 intp characters (2.

At 180 days chronic progressive external ophthalmoplegia follow-up, hospitalizations for ADHF were reported in a total of 31 (34. Hospitalization for causes other than HF was reported in 14 (16. Beyond 180 days of follow-up, hospitalizations for ADHF were reported in 44 (48.

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24.05.2019 in 01:02 Mikar:
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