Infusion Clinic
Intravenous medication infusion therapy is another treatment option for a patient diagnosed with congestive heart failure (CHF) with severe symptoms and is resistant to oral medications. Infusion therapy may be temporary to allow for adjustment in medications or life long in the case of end stage congestive heart failure.

Infusion therapy is usually indicated for four reasons:

1. Temporary treatment for acute worsening of heart failure that does not respond to appropriate doses of oral medications.
2. Worsening heart failure that is accompanied by low blood pressure and renal failure.
3. A bridge to heart transplantation or recovery from a myocardial infarction (heart attack).
4. Reduction of symptoms for patient who are not candidates for heart transplantation but in whom symptoms are severe despite being on maximal oral medical therapy.

Infusion therapy is performed in an outpatient setting. At Poudre Valley Hospital in Fort Collins Colorado, CHF infusion therapy is administered to patients in the Heart Center Procedure Unit (HCPU) by a registered nurse (RN) who is under the supervision of a cardiologist (MD) and a nurse practitioner (NP) or a physician's assistant (PA). Other sites include McKee Medical Center in Loveland Colorado and Sterling Regional Medical Center in Sterling Colorado.

Infusions are tailored to fit each patient and are usually given 1-3 times per week. The duration of each infusion is typically 4 hours. The patient has a peripherally inserted central catheter (IV PICC) inserted into the vein of his/her arm by either IV team or the radiology department. The PICC line allows for ease of blood draws for laboratory tests and for infusion of mediations. The PICC line may be used indefinitely, and only needs to be changed if it clots or is infected.

There are several combinations of medications that may be used to help improve your symptoms caused by heart failure. Commonly used IV medications to increase the force of the heart's contractions are milrinone (Primacor) and Dobutamine. Commonly used medications to help remove fluid accumulation are nesiritide (Natrecor), furosemide (Lasix), and bumetanide (Bumex). Your cardiologist and the mid level practitioners (NP or PA) that manage the infusion clinic determine the appropriate medication for you.

The goals of the infusion clinic are to prevent further hospitalizations for heart failure and to improve the quality of life by reducing the symptoms of heart failure.