eprintid: 269007 rev_number: 33 eprint_status: archive userid: 45630 dir: disk0/00/26/90/07 datestamp: 2022-04-12 13:30:24 lastmod: 2022-05-23 11:40:07 status_changed: 2022-04-12 13:30:24 type: article metadata_visibility: show creators_name: Girerd, Nicolas creators_name: Newton, Nathan creators_name: Tartière, Jean-Michel creators_name: Guijarro, Damien creators_name: Jourdain, Patrick creators_name: Damy, Thibaud creators_name: Lamblin, Nicolas creators_name: Bayes-Génis, Antoni creators_name: Pellicori, Pierpaolo creators_name: Januzzi, James creators_name: Rossignol, Patrick creators_name: Roubille, François creators_orcid: 0000-0001-7175-0464 title: Practical outpatient management of worsening chronic heart failure ispublished: pub divisions: 25606000 full_text_status: public abstract: Management of worsening heart failure (WHF) has traditionally been hospital-based, but with the rising burden of HF, the pressure on health care systems exerted by this disease necessitates a different strategy than long (and costly) hospital stays. A strategy for outpatient intravenous (IV) diuretic treatment of WHF has been developed in certain American centers in the past 10 years, whereas European centers have been mostly favoring “classic” in-hospital management of WHF. Embracing novel, outpatient approaches for treating WHF could substantially reduce the burden on healthcare systems while improving patient's satisfaction and quality of life. The present article is intended to provide essential knowledge and practical guidelines aimed at helping clinicians implement these new ambulatory approaches using day hospital and/or at-home hospitalization. The topics addressed by our group of HF experts include the pathophysiological background of diuretic therapy, the most suitable profile of WHF that may be managed in an ambulatory setting, the pharmacological protocols that can be used, as well as a detailed description of healthcare structures that can be proposed to deliver these ambulatory care interventions. The practical aspects of day hospital and Hospital-at-Home (HaH) IV diuretics administration are specifically emphasized. The algorithm provided along with the practical IV diuretics protocols should assist HF clinicians in implementing this new approach in their local clinical setting. date: 2022-05 date_type: published publication: European Journal of Heart Failure volume: 24 number: 5 publisher: Wiley pagerange: 750-761 id_number: 10.1002/ejhf.2503 refereed: TRUE issn: 1388-9842 copyright_holders: Copyright © 2022 The Authors prior: First published in European Journal of Heart Failure 24(5): 750-761 repro: Reproduced under a Creative Commons License uniqueid: glaseprints:2022-269007 issn_online: 1879-0844 pubmed_id: 35417093 euro_pubmed_id: 35417093 hoa_compliant: 9215 hoa_emb_len: 0 hoa_ref_pan: AB hoa_date_acc: 2022-04-11 hoa_date_pub: 2022-04-13 hoa_date_foa: 2022-04-27 hoa_version_fcd: AM hoa_exclude: FALSE hoa_gold: TRUE oa_research_materials_ack: No rioxx2_license_ref_input_license_ref: https://creativecommons.org/licenses/by-nc/4.0/ rioxx2_license_ref_input_start_date: 2022-04-27 rioxx2_apc_input: unknown citation: Girerd, N. et al. (2022) Practical outpatient management of worsening chronic heart failure. European Journal of Heart Failure , 24(5), pp. 750-761. (doi: 10.1002/ejhf.2503 ) (PMID:35417093) document_url: https://eprints.gla.ac.uk/269007/1/269007.pdf