Natalia Henao, Departamento de Medicina Interna y Especialidades Médicas, Hospital Pablo Tobón Uribe, Medellín, Colombia
Yuly J. Rojas, Departamento de Medicina Interna y Especialidades Médicas, Hospital Pablo Tobón Uribe, Medellín, Colombia
Mónica Zuluaga, Departamento de Medicina Interna y Especialidades Médicas, Hospital Pablo Tobón Uribe, Medellín, Colombia
Juan C. Chavarriaga, Departamento de Medicina Interna y Especialidades Médicas, Hospital Pablo Tobón Uribe, Medellín, Colombia
Natalia A. Arboleda, Departamento de Medicina Interna y Especialidades Médicas, Hospital Pablo Tobón Uribe, Medellín, Colombia
Introduction: Heart failure has high prevalence, mortality and is the cause of frequent hospitalizations due to acute decompensation with congestion. Diuretics are the cornerstone of treatment. Objective: To describe the results of applying a decongestion protocol in a population with acute decompensated heart failure in a high-complexity center. Methods: Descriptive, retrospective study that included patients > 18 years old with decompensated heart failure and congestive signs, hospitalized for more than 24 hours in a high complexity center and in whom an institutional decongestion protocol was applied. Results: 55 patients with decompensated heart failure were included. Adherence to the protocol with initial bolus administration of furosemide was 85% and, in 82% of cases, the door-to-diuretic time was less than 1 hour. Urinary sodium was below the goal in 3.6% of patients. A median diuresis of 2.4 L is achieved. No patient developed acute kidney injury during hospitalization or upon discharge. The median hospitalization was 5 days, with 3.6% mortality and 9% readmissions due to heart failure at 30 days. Conclusions: The aggressive decongestion protocol resulted in a short hospital stay, low mortality, and readmissions. The risk of hypotension, renal failure, or electrolyte disorders was not increased.
Keywords: Heart failure. Diuretics. Furosemide.
