A 85-year-old man with severe frailty (CFS 7) and advanced heart failure is in a care home. He has been deteriorating over weeks with increasing breat...

Question

A 85-year-old man with severe frailty (CFS 7) and advanced heart failure is in a care home. He has been deteriorating over weeks with increasing breathlessness, oedema, and fatigue despite maximum medical therapy. He is no longer able to leave his room. His prognosis is estimated at weeks to months. What is the MOST appropriate approach to his diuretic therapy?

Accepted Answer

Continue Furosemide at a dose titrated to symptom relief, with regular assessment of fluid status and renal function

Answer

Stop all diuretics as he is at end of life

Answer

Increase Furosemide to maximum dose regardless of renal function

Answer

Switch from Furosemide to Spironolactone for better symptom control

Answer

Add intravenous Furosemide via a syringe driver

uk-dgm MCQ (SBA): Diuretic Management in End-Stage Heart Failure