BMJ Support Palliat Care 3:7-9 doi:10.1136/bmjspcare-2012-000296
  • Letters

Subcutaneous furosemide as palliative treatment in patients with advanced and terminal-phase heart failure

  1. Manuel Ollero-Baturone1
  1. 1 Department of Internal Medicine Hospital, Universitario Virgen del Rocío, Seville, Spain
  2. 2 Department of Clinical Pharmacology, Hospital Universitario Virgen del Rocío, Seville, Spain
  1. Correspondence to Dr Javier Galindo-Ocaña, Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n., Sevilla 41013, Spain; galinx3{at}

We have read with great interest the editorial by Beattie and Johnson,1 discussing the role of subcutaneous furosemide (SCF) as an off-label palliative symptomatic treatment feasible for patients with decompensated advanced heart failure (DAHF), whose preferences led to being attended to in their homes, thus avoiding inappropriate hospitalisations, as demonstrated by Zacharias and Johnson in their recently published study.2

In this sense, we have performed an observational retrospective study with the aims to determine the effects of SCF dose amount on hospital length of stay, and time to symptom improvement, among patients with DAHF. We also compared the results with a cohort of patients treated with intravenous furosemide on wards.

Between January 2008 and January 2012, all episodes of DAHF consecutively attended to at home were recruited. Inclusion criteria were: older than 18 years, heart failure, New York Heart Association (NYHA) class III or IV symptoms, treated at home with SCF by a Southern Spanish university hospital at-home unit. Analysed variables were: number of hospital admissions before …

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