Subcutaneous Furosemide in Acute Decompensated Heart Failure: The SUBQ-HF Study
To determine if a strategy of early discharge using a novel subcutaneous delivery system for parenteral furosemide can improve clinical outcomes within 30 days of randomization (days alive and outside the hospital) compared to usual care.
• Age \>18 years
• Willingness and ability to provide informed consent
• Hospitalization for AHF with at least 1 symptom (dyspnea, orthopnea, or edema) AND 1 sign (rales on auscultation, peripheral edema, ascites, pulmonary vascular congestion on chest radiography, BNP \> 250 ng/mL or NTproBNP \> 1000 ng/mL) of congestion
• Persistent congestion defined by the presence of at least 2 or more of the following at the time of consent:
‣ Peripheral edema
⁃ Rales
⁃ Elevated JVP
⁃ Ascites
⁃ BNP \> 250 ng/mL or NTproBNP \> 1000 ng/mL during index hospitalization
⁃ Orthopnea
• Total anticipated daily IV furosemide dose (at time of screening) \>80-240 mg (or equivalent)/day
• Anticipated need for at least 24 more hours of parenteral diuretic therapy
• Age \>18 years
• Willingness and ability to provide informed consent
• HF now presenting with volume overload defined by the presence of at least 2 or more of the following at the time of consent:
‣ Peripheral edema
⁃ Rales
⁃ Elevated JVP
⁃ Ascites
⁃ BNP \> 250 ng/mL or NTproBNP \> 1000 ng/mL during this episode of decompensation
⁃ Orthopnea
• Need for parenteral furosemide with an estimated SQ furosemide requirement between 80-240 mg/day
• Anticipated need for at least 24 hours of parenteral diuretic therapy