Skip to main content

Advertisement

SpringerLink
Log in

The use of positive inotropes in end-of-life heart failure care

  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

End-stage heart failure is associated with mortality equivalent to cancer, yet there is little information about palliative therapy for this disease. Chronic outpatient support with inotropes provides symptomatic relief and life extension for those select patients demonstrating dependence on positive inotropic therapy. The purpose of this review is to provide information about process and implementation of chronic outpatient support with inotropes in patients with end-stage heart failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Rosamond W, Flegal K, Friday G, et al.: American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Heart disease and stroke statistics—2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2007, 115:e69–e171.

    Article  PubMed  Google Scholar 

  2. Ørn S, Dickstein K: How do heart failure patients die? Eur Heart J 2002, 4(Suppl D):D59–D65.

    Article  Google Scholar 

  3. Bardy GH, Lee KL, Mark DB, et al.: Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Medi 2005, 352:225–237.

    Article  CAS  Google Scholar 

  4. Hunt SA, Abraham WT, Chin MH, et al.: ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2005, 112:e154–e235.

    Article  PubMed  Google Scholar 

  5. Hershberger RE, Nauman D, Walker TL, et al.: Care processes and clinical outcomes of continuous outpatient support with inotropes (COSI) in patients with refractory endstage heart failure. J Card Fail 2003, 9:180–187.

    Article  PubMed  Google Scholar 

  6. Rose EA, Gelijns AC, Moskowitz AJ, et al.: Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med 2001, 345:1435–1443.

    Article  PubMed  CAS  Google Scholar 

  7. Hobbs FDR: The scale of heart failure: diagnosis and management issues for primary care. Heart 1999, 82(Suppl IV):IV8–IV10.

    PubMed  Google Scholar 

  8. Zambroski CH, Moser DK, Roser LP, et al.: Patients with heart failure who die in hospice. Am Heart J 2005, 149:558–564.

    Article  PubMed  Google Scholar 

  9. Goodlin SJ, Hauptman PJ, Arnold R, et al.: Consensus statement: Palliative and supportive care in advanced heart failure. J Card Fail 2004, 10:200–209.

    Article  PubMed  Google Scholar 

  10. Teno JM, Weitzen S, Fennel ML, et al.: Dying trajectory in the last year of life: does cancer trajectory fit other diseases? J Palliat Med 2001, 4:457–464.

    Article  PubMed  CAS  Google Scholar 

  11. McClung JA: End-of-life care in the treatment of heart failure in the elderly. Clin Geriatr Med 2007, 23:235–248.

    Article  PubMed  Google Scholar 

  12. Kutner JS, Cordt TK, Nowels DE: Sympton burden at the end of life:hospice providers’ perceptions. J Palliat Med 2001, 21:473–480.

    CAS  Google Scholar 

  13. Gibbs JS, McCoy AS, Gibbs LM, et al.: Living with and dying from heart failure: the role of palliative care. Heart 2002, 88(Suppl 2):ii36–ii39.

    PubMed  Google Scholar 

  14. Harjai KJ, Mehra MR, Ventura HO, et al.: Home inotropic therapy in advanced heart failure: cost analysis and clinical outcomes. Chest 1997, 112:1298–1303.

    Article  PubMed  CAS  Google Scholar 

  15. Sindone AP, Keogh AM, Macdonald PS, et al.: Continuous home ambulatory intravenous inotropic drug therapy in severe heart failure: safety and cost efficacy. Am Heart J 1997, 134:889–900.

    Article  PubMed  CAS  Google Scholar 

  16. Upadya S, Lee FA, Saldarriaga C, et al.: Home continuous positive inotropic infusion as a bridge to cardiac transplantation in patients with end-stage heart failure. J Heart Lung Transplant 2004, 23:466–472.

    Article  PubMed  Google Scholar 

  17. Brozena SC, Twomey C, Goldberg LR, et al.: A prospective study of continuous intravenous milrinone therapy for status IB patients awaiting heart transplant at home. J Heart Lung Transplant 2004, 23:1082–1086.

    Article  PubMed  Google Scholar 

  18. Rich MW, Shore BL: Dobutamine for patients with end-stage heart failure in a hospice program? J Palliat Med 2003, 6:93–97.

    Article  PubMed  Google Scholar 

  19. Jimenez J, Jara J, Bednar B, et al.: Long-term (> 8 weeks) home inotropic therapy as destination therapy in patients with advanced heart failure or as bridge to heart transplantation. International J Cardiol 2005, 99:47–50.

    Article  Google Scholar 

  20. Teuteberg JJ, Lewis EF, Nohria A, et al.: Characteristics of patients who die with heart failure and a low ejection fraction in the new millennium. J Card Fail 2006, 12:47–53.

    Article  PubMed  Google Scholar 

  21. Felker GM, O’Connor CM: Inotropic therapy for heart failure: an evidence-based approach. Am Heart J 2001, 142:393–401.

    Article  PubMed  CAS  Google Scholar 

  22. Hauptman PJ, Mikolajczak P, George A, et al.: Chronic inotropic therapy in end-stage heart failure. Am Heart J 2006, 152:1096.e1–1096.e8.

    Article  Google Scholar 

  23. POLST.org. Physician Orders for Life-Sustaining Treatment Program. http://www.ohsu.edu/ethics/polst. Accessed March 7, 2007.

  24. Goldstein NE, Lampert R, Bradley E, et al.: Management of implantable cardioverter defibrillators in end-of-life care. Ann Intern Med 2004, 141:835–838.

    PubMed  Google Scholar 

  25. Irvine J, Dorian P, Baker B, et al.: Quality of life in the Canadian Implantable Defibrillator Study (CIDS). Am Heart J 2002, 144:282–289.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA

    Deirdre J. Nauman

Authors
  1. Deirdre J. Nauman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ray E. Hershberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Deirdre J. Nauman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nauman, D.J., Hershberger, R.E. The use of positive inotropes in end-of-life heart failure care. Curr Heart Fail Rep 4, 158–163 (2007). https://doi.org/10.1007/s11897-007-0035-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11897-007-0035-0

Keywords

Search

Navigation