[Dobutamine therapy at home under the guidance of a nurse practitioner, either as a bridge to cardiac transplantation or as destination therapy in severe heart failure].

OBJECTIVE

To evaluate the results of intravenous dobutamine therapy at home for ambulatory patients with severe heart failure.

DESIGN

Retrospective.

METHOD: Data were retrieved for the 40 patients that had been treated with intravenous dobutamine at home during the period from 1 January 1994 until mid-November 2006 at the Thorax Centre of Groningen University Medical Centre, The Netherlands. The patients were guided by a nurse practitioner.

RESULTS

The study group comprised 31 men and 9 women. The 22 patients on the waiting list for a heart transplant had an average age of 49 years. For the other 18 patients, on average 63 years old, it was destination therapy. The mean administered dosage ofdobutamine was 4 microg/kg/ min (range: 2-10). Pre-transplantation and destination therapy were given for an average of 3.5 and 1.5 months, respectively. A successful transplantation was performed in 14 (64%) of the 22 waiting-list candidates; 2 patients were still on the waiting list and 6 died while on the waiting list. Intravenous access complications and ICD shocks each occurred in 6 (15%) patients. The quality of life was reasonable to fair in the waiting-list patients and moderate to reasonable in those given destination therapy. The costs for medication and hire of the infusion pump were Euro 450 per month.

CONCLUSION

Dobutamine infusion therapy at home under the guidance of a nurse practitioner, either as a bridge to cardiac transplantation or as destination therapy in patients with severe heart failure, appeared safe, feasible and not expensive.