How safe is inotrope therapy in the home?
Study points to safety and cost efficacy
A study published in the American Heart Journal found that continuous home intravenous inotropic drug therapy is safe and cost-efficient.1 The study followed 20 patients awaiting heart transplantation who were unable to be weaned from intravenous inotropic therapy on two or more occasions, but were stable while receiving inotrope infusion therapy in the home.
Thirteen patients received dopamine, four received dobutamine, and three received both. The mean duration of the therapy was five months, 70% of which was spent as an outpatient. When the study was completed, 11 patients received transplants, two were still on the waiting list, and seven died after having been removed from the list because of general deterioration or renal dysfunction. Survival was 71% at three months, which is expected for an inotrope-dependent population.
All patients with idiopathic dilated cardiomyopathy survived to transplantation, while all three patients with right heart failure caused by pulmonary vascular disease and four of seven patients with cardiomyopathy died. Inpatient days for the 20 patients were reduced by 70%.
Reference
1. Sindone A, Keogh M, Macdonald P, et. al. Continuous home ambulatory intravenous inotropic drug therapy in severe heart failure: safety and cost efficacy. Am Heart J 1997; 134:889-900.
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