Application of a rapid decongestion protocol for patients with acute heart failure

Introduction: Heart failure has a high prevalence and mortality and is the cause of frequent hospitalizations due to acute decompensation with congestion.Diuretics are the cornerstone of treatment.Objective: To describe the results of applying a decongestion protocol in a population with acute decompensated heart failure in a tertiary care center.Methods: Descriptive, retrospective study that included patients > 18 years old with decompensated heart failure and congestive signs, hospitalized for more than 24 hours in a high complexity center and in whom an institutional decongestion protocol was applied.Results: Fifty-five patients with decompensated heart failure were included.There was 85% adherence to the protocol with the initial bolus administration of furosemide and, in 82% of cases, the door-to-diuretic time was less than 1 hour.Urine sodium was below target in 3.6% of patients.A median diuresis of 2.4 L was achieved.None of the patients developed acute kidney injury during hospitalization or upon discharge.The median hospitalization was five days, with 3.6% mortality and 9% readmissions for heart failure within 30 days.Conclusions: The aggressive decongestion protocol resulted in a short hospital stay, low mortality, and few readmissions.The risk of hypotension, renal failure, or electrolyte disorders did not increase.