Early Discharge With Subcutaneous Furosemide Versus Standard Care in Acute Heart Failure

Launched by UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER · Jun 4, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether patients with acute heart failure can safely go home early with a medication called subcutaneous furosemide, instead of staying in the hospital for standard care. The goal is to see if this early discharge approach allows patients to spend more days at home and out of the hospital within 30 days. The trial will involve about 250 participants who are hospitalized or are being observed for heart failure. It will use a method where different groups of doctors will try out either the early discharge or the standard care for two months before switching to the other approach.

To be eligible for this trial, participants need to be 18 years or older and must be admitted to the hospital or emergency department within the last 48 hours with heart failure. They should require at least 24 more hours of a specific type of medication (IV diuretics) and have a suitable home environment for self-care. Participants will need to be capable of using a device to deliver the medication at home. However, individuals with certain health issues, such as severe kidney problems or cognitive impairments, won’t be eligible. If you or a loved one is considering participating, you can expect to receive either early discharge with the medication or the usual hospital care, depending on which group you are in at the time.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age ≥ 18 years
• • Within 48 hours of inpatient stay OR ED presentation for HF with plans for admission OR observation stay/short-stay hospitalization for HF
• • Expected to require at least 24 additional hours of IV diuretics
• • Adequate home environment for self-care
• • Patient or caregiver capable of operating subcutaneous delivery device
• Exclusion Criteria:
• • Cognitive impairment preventing informed consent
• • Geographic barriers to follow-up
• • Pregnancy or breastfeeding
• • IV furosemide requirement \>250mg/day
• • eGFR \<20 mL/min/1.73m2
• • Type 1 myocardial infarction during index admission
• • End-stage HF with receipt or consideration of heart transplant or LVAD or requiring inotropic or mechanical circulatory support
• • Potassium \<3.0 or \>6.0 mmol/L or sodium \<125 mmol/L