Subcutaneous Frusemide in patients with heart failure

The proposed study is a single centre, prospective, feasibility study measuring the effectiveness of continuous sc Frusemide (CSI-F) in achieving a diuresis in patients with decompensated heart failure.Eligible patients with decompensated heart failure who are admitted to Auckland City Hospital will be treated for the first 24 hours with usual therapy (as per Consultant Cardiologist). After 24 hours of usual care, and after obtaining informed consent, patients will receive Frusemide via a continuous subcutaneous infusion.A Safe-T Intima sc cannula will be inserted with an aseptic technique under the skin by the researcher or patients nurse. The infusion dosage will run as per Consultants medical orders via a Niki T34 syringe driver. The dose of Frusemide will be decided by the Cardiology Consultant responsible for the patients care, and will usually be dose for dose that which would be administered IV. Baseline recordings will be taken such as blood pressure (BP), heart rate (HR), respiratory rate (RR), temperature and weight will be taken prior to infusion.Primary outcome measures will be of net urine volume voided, urine sodium concentration, time to first void, weight, breathlessness and peripheral oedema score.Secondary outcome measures will be serum creatinine, site reactions, length of hospital stay, and number of days out of hospital.