Subcutaneous furosemide using the standard formulation avoided hospital admission in 64% of patients with worsening heart failure and reduced median BNP by 43.6%.
Observational (n=11)
Does standard formulation subcutaneous furosemide delivered via a nurse-led integrated service improve outcomes and avoid hospitalization in patients with worsening heart failure?
Home-based subcutaneous furosemide using the standard formulation is a feasible, safe, and effective alternative to intravenous diuresis for worsening heart failure, avoiding hospitalization in the majority of patients.
Abstract Background Subcutaneous (s/c) furosemide provides a practical alternative to intravenous (IV) diuresis for patients with fluid overload. While its buffered formulation is established in palliative care, evidence supporting the use of the standard formulation in heart failure (HF) management, particularly within integrated care pathways, remains limited. Aim To evaluate the clinical effectiveness, tolerability, and outcomes of the standard formulation of s/c furosemide administered within a nurse-led, hospital–community integrated HF service. Methods An audit of 11 consecutive patients with worsening HF (NYHA II–IV) was undertaken. Eligible patients identified by the hospital HF nurse were referred to the Community Intervention Team (CIT) for home administration of s/c furosemide via syringe pump. The CIT nurse replaced the syringe daily, monitored vital signs, and performed blood sampling, while the HF nurse reviewed results virtually and followed up each patient post-treatment. Data collected included demographics, renal function, B-type natriuretic peptide (BNP), treatment duration, weight change, adverse effects, and hospitalisation outcomes. Results Median age was 83 years (IQR 81–86); median eGFR 33.4 mL/min/1.73 m². Median duration of therapy was 4 days (IQR 3.2–4.0). BNP decreased from 2734 to 1542 pg/mL (median reduction = 1192; 43.6%), and weight by 2.2 kg (IQR 0.9–3.2). No local site reactions occurred. Hospital admission was avoided in 7/11 patients (64%); renal function remained stable. Conclusion Subcutaneous furosemide using the standard formulation was safe, effective, and well-tolerated when delivered through a nurse-led, integrated HF service. This model offers a feasible alternative to IV diuresis when IV access is challenging or community capacity allows, supporting patient-centred, home-based care.
N Caples (Wed,) conducted a observational in worsening heart failure (NYHA II-IV) (n=11). standard formulation of subcutaneous furosemide was evaluated on hospital admission avoided. Subcutaneous furosemide using the standard formulation avoided hospital admission in 64% of patients with worsening heart failure and reduced median BNP by 43.6%.