Oral dIuretics in Very Intensive Treatment, an Early Intervention in Outpatients With Heart Failure

Exclusion Criteria

• •1. Pregnant or lactating women.
• •2. Patients with deterioration of their clinical condition that warrant rapid attention by the emergency department.
• •3. Patients with symptomatic hypotension by arterial pressure over; 90/50 mmHg.
• •4. Symptomatic heart rate disorders: tachycardia greater than 120 beats per minute or bradycardia less than 50 beats per minute.
• •5. Patients with respiratory impairment: by tachypnea (respiratory rate greater than 22 per min), peripheral oxygen saturation less than 90%.
• •6. Clinical signs or by methods of pleural effusion image that compromise the ventilatory mechanism.
• •7. Hormonal thyroid decontrol (thyroid hormone profile outside the reference range)
• •8. Serum glucose numbers greater than 140mg/DL and/or glycosylated hemoglobin greater than 6.5%.
• •9. Renal damage characterized by serum creatinine numbers greater than 1.5 mg/DL.
• •10. Alteration of the hepatic test: serum aspartate aminotransferase and/or serum alanine aminotransferase by levels greater than three times the upper limit of reference.
• •11. Alterations in serum electrolytes (by sodium greater 135 mmol/L or less 145 mmol; Potassium less than 3.5 mmol/L or higher 5.35 mmol/L)
• •12. Intolerance or allergy recognized for any diuretic.
• •13. Comorbidities that prevent the follow-up of treatment: (Alcoholism, drug addiction, psychiatric disorders)
• •14. Positive serology carriers for Hepatitis (B, C) HIV.
• •15. Acute myocardial infarction (with and without elevation) in the last three months.
• •16. History of vascular (ischemic or hemorrhagic) brain disease in the last three months.
• •17. Carriers of acute inflammatory and/or immunologic disease in the last three months (e.g. Active Lupus etc.)
• •18. Active myocarditis in the last three months
• •19. History of Prostatism, or recognized prostatic alterations, that impede voiding flow.
• •20. Terminal cancer
• •21. Blunt physical and cognitive deterioration that prevents optimal follow-up.
• •22. Cultural barriers involving limitation of communication (languages, dialects, reading and writing, etc.).
• •23. Not to sign informed consent
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