Regular At‐home Abdominal Paracentesis via Tenckhoff Catheter in Patients with Refractory Congestive Heart Failure

2021 ◽  
Author(s):  
Margarita Kunin ◽  
Sharon Mini ◽  
Nabil Abu‐Amer ◽  
Pazit Beckerman
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Tenckhoff Catheter ◽  
Abdominal Paracentesis ◽  
At Home

Impact of telemonitoring at home on the management of elderly patients with congestive heart failure

2008 ◽  
Vol 14 (6) ◽  
pp. 300-305 ◽  
Author(s):  
Roberto Antonicelli ◽  
Paolo Testarmata ◽  
Liana Spazzafumo ◽  
Cristina Gagliardi ◽  
Grzegorz Bilo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Elderly Patients ◽  
At Home

Home Intermittent Amrinone Infusions in Terminal Congestive Heart Failure

DICP ◽  
1989 ◽  
Vol 23 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Richard J. Baptista ◽  
Francis P. Mitrano ◽  
Joanne Perri-Lafrancesca
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Central Venous Catheter ◽  
Infusion Pump ◽  
Venous Catheter ◽  
Pilot Program ◽  
Central Venous ◽  
At Home

The prevalence of congestive heart failure (CHF) and its progressive degenerative course continue to generate pressure for alternative, more effective means of treatment. A confluence of factors, including the number of Americans with CHF, the spiraling costs of hospital care, and increasing interest in cost-effective home care, contribute to the current efforts to develop an effective, nontoxic therapy that effectively increases myocardial contractility and output and can be administered within the confines of the home. Given that preliminary clinical trials in the hospital setting with amrinone have produced positive results, the transition of this therapy to the home, when administered intermittently via central venous catheter and infusion pump, was undertaken. In order to prolong and increase quality of life in terminal CHF patients, intermittent amrinone infusions were provided at home to four patients as part of our pilot program. All four patients met the criteria for New York Heart Association (NYHA) functional class IV heart failure, and none had responded to conventional therapy suitable for outpatient maintenance. The patients also shared strong family support and an intense desire to improve the quality of remaining life. All four patients and designated family members were trained in the specifics of aseptic technique, medication dose preparation, central venous catheter care, and operation of an infusion pump. An ambulatory pump was used in three of the four patients. Subsequent to the initiation of intermittent home amrinone infusions, all four patients had greater tolerance to limited exercise and/or ambulation secondary to increased cardiac output and diuresis. Patients survived 8, 10, 47, and 56 weeks. This pilot program suggests that intravenous amrinone, administered intermittently at home, appears reasonably safe and might promote an improved quality of life. More research is necessary prior to substantiating any firm conclusions.

scholarly journals Examination about more realistic prognosis evaluation method, how long the patients with congestive heart failure can spend at home

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Takaishi ◽  
T Iida ◽  
T Kishinoue ◽  
H Mori ◽  
T Yamaji ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Clinical Pathway ◽  
Readmission Rate ◽  
Evaluation Method ◽  
Clinical Course ◽  
Total Period ◽  
Clinical Prognosis ◽  
Hospitalization Period ◽  
At Home

Abstract Background From August 2015, for efficient medical care in congestive heart failure (CHF) cases, we had introduced a unique clinical pathway (PATH) provided the immediate use of Tolvaptan and comprehensive education by multi-disciplinary staff after admission. And by introduction of PATH, we confirmed the shortening effect of hospitalization period with CHF and the suppressive effect of readmission with CHF after discharge. But since almost CHF patients repeat hospitalization and discharge due to change of their medical condition, the investigation for only first readmission rate after discharge is not enough to assess the entire long clinical course of CHF. Recently we found one report about evaluation method for CHF clinical prognosis, how long CHF patients can stay healthy at their own home after discharge within a certain period. This evaluation method is considered to take into account the long clinical course of CHF. Purpose We investigated whether the CHF patients introduced PATH on admission could stay longer at their home than CHF patients without PATH. Methods Between April 2014 and July 2019, 471 CHF cases, who ware admitted in our hospital at first and could be followed up for at least 1 month after discharge, ware enrolled. We divided them to two groups, PATH- group before introducing PATH (until July 2015, 142 cases), and PATH+ group applied PATH (after August 2015, 329 cases). Between both groups, we investigated the readmission rate (RR) with CHF and the total period (TP) that patients could spend at home within1, 3, 6 and 12month after discharge. Results There were no significant differences in mean age, pre-hospital living status, or clinical status at admission between the two groups. On the other hand, due to efficient CHF care, the average length of hospital stay was significantly shorter (figure1). RR within 1, 3, 6 and 12 months after discharge ware all lower in PATH+ group. And TP within 1, 3, 6 and 12 months after discharge ware all longer in PATH+ group (figure2). Conclusion By introducing our unique clinical pathway for congestive heart failure cases requiring hospitalization, we could confirm not only the improvement of their conventional clinical prognosis index but also the improvement of their new and more realistic clinical prognosis index after discharge. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

Ground-Level Falls at Skilled Nursing Facilities Are Associated With More Serious Lower Extremity Injuries Compared With Home

2019 ◽  
Vol 19 (2) ◽  
pp. 190-196
Author(s):  
Bima J. Hasjim ◽  
Areg Grigorian ◽  
Catherine M. Kuza ◽  
Sebastian Schubl ◽  
Cristobal Barrios ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Lower Extremity ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Ground Level ◽  
Femur Fractures ◽  
Stage Renal Disease ◽  
End Stage ◽  
At Home

Ground-level falls (GLFs) are the number one cause of injury and death in the older adult population. We compared injury profiles of GLFs at SNFs to those at homes, hypothesizing that GLFs at SNFs would lead to higher risks for serious (AIS ≥ 3) traumatic brain injury (TBI) and lower extremity (LE) injuries compared to GLFs at home. The 2015-2016 Trauma Quality Improvement Program was used to compare patients sustaining GLFs at home and SNFs. From 15,873 patients sustaining GLFs, 14,306 (90.1%) occurred at home while 1,567 (9.9%) at SNFs. More patients with GLFs at SNFs were female, older, and had greater incidence of congestive heart failure, end-stage renal disease, and dementia ( p < 0.001) compared to those at home. Although, GLF SNF patients had lower injury severity scores (9 vs. 10, p < 0.001) and incidence for TBI (28.0% vs 33.4%, p < 0.001), they had a higher rate of femur fractures (55.1% vs. 38.9%, p < 0.001). After controlling for female, end stage renal disease, smoking, dementia, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, and stroke, patients falling at SNFs had an increased risk of sustaining serious LE injury AIS (OR 1.64, p < 0.001), but not serious TBI AIS (OR 0.89, p = 0.073). In conclusion, compared to GLFs at home, those at SNFs have a higher risk for serious LE injury, with femur fractures being the most common. However, GLFs at SNFs and homes had no significant difference in risk for serious TBI. Future studies are warranted to evaluate preventative measures to reduce LE injuries at SNFs.

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