Critical care management of the heart failure patient in the home

: Deaths due to cardiovascular disease have decreased as the result of advances in medical therapeutics, advanced technology, and health promotion activities. Increased survival has resulted in a significant rise in the number of patients with chronic, refractory heart failure requiring intensive medical management and follow-up. Home care nurses trained in advanced cardiac assessment can decrease the cost of care by providing advanced technologic care in the home. Home dobutamine infusions are one example of provision of high-technology services in the home. With careful patient selection, adequate preparation, and home monitoring, dobutamine infusions can be provided in the home to improve the functional status and quality of life of patients with severe heart failure.