This Minute CE examines the recognition and outpatient management of congestion in patients with heart failure (HF) and/or chronic kidney disease (CKD). Expert faculty discuss clinical and biomarker indicators of early volume overload, factors that may delay recognition, and practical approaches to outpatient assessment. In addition, faculty review the pharmacologic and clinical rationale for subcutaneous furosemide, including evidence related to bioequivalence, safety, dosing, and implementation. Faculty also explore how remote patient monitoring metrics, such as weight, pulmonary artery pressure, and blood pressure, can inform timely outpatient diuresis and be incorporated into clinical workflows. Case-based and expert discussions address multidisciplinary care pathways, coordination of subcutaneous furosemide across care settings, documentation and safety monitoring, and quality metrics—including readmissions, length of stay, adherence, bed-day avoidance, and patient satisfaction—for evaluating outpatient decongestion strategies.
Fluid Forward: Reimagining Decongestion Beyond the Hospital Walls
Disclosure of Relevant Financial Relationships
In accordance with the ACCME Standards for Integrity and Independence, Global Learning Collaborative requires all faculty and planners to disclose financial relationships with ineligible companies. All relevant financial relationships have been reviewed and mitigated to ensure that the content is free from commercial bias.
The following faculty and planners have disclosed relevant financial relationships with ineligible companies in the past 24 months.
Faculty:
Brian P. Rose, PA-C, MPH
Cardiology Physician Associate
Department of Cardiology
First Health of the Carolinas
Pinehurst, NC
Consulting Fees: Esperion, iRhythm, Lexicon, MannKind, Milestone
Research: Bayer
Craig J. Beavers, PharmD, FACC, FAHA, FCCP, BCCP, BCPS-AQ Cardiology, CACP
Vice President of Operations
University of Kentucky
Paducah, KY
Research: Bayer
Daniel R. Bensimhon, MD
Medical Director, Advanced Heart Failure & Mechanical Circulatory Support Program
Cone Health
Greensboro, NC
Consulting Fees: AquaPass, AstraZeneca, Bayer, Boehringer Ingelheim/Eli Lilly, Caption Health, Corstasis, Janssen, Merck, Pfizer, scPharmaceuticals, Sensible Medical
Stock Ownership: AquaPass, Corstasis, HeartFlow, scPharmaceuticals, Sensible Medical, Ventricle Health
Other: Ventricle
Stephanie Barnes DNP, AGPNP-C, CHFN
Clinical Director for Advanced Heart Failure
Duke University Health System
Durham, NC
Consulting Fees:CVRx
Reviewers/Planners/Authors:- Cindy Davidson has no relevant relationships to disclose.
- Katie Sheridan, PhD, has no relevant relationships to disclose.
- Brian P. McDonough, MD, FAAFP, has no relevant relationships to disclose.
Learning Objectives
Upon completion of this activity, learners should be better able to:
- Identify clinical and biomarker indicators of early volume overload in patients with heart failure and/or chronic kidney disease to guide timely outpatient intervention
- Apply evidence-based strategies for managing congestion outside the hospital setting, including subcutaneous furosemide use when clinically appropriate
- Explain how remote patient monitoring data can be integrated with outpatient diuretic management to reduce heart failure readmissions
Target Audience
This activity has been designed to meet the educational needs of cardiologists and primary care physicians as well as all other physicians, physician assistants, nurse practitioners, nurses, pharmacists, and healthcare professionals involved in managing patients with heart failure.
Accreditation and Credit Designation Statements
In support of improving patient care, Global Learning Collaborative (GLC) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
Global Learning Collaborative (GLC) designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Global Learning Collaborative (GLC) designates this activity for 1.00 nursing contact hour(s). Nurses should claim only the credit commensurate with the extent of their participation in the activity.
Global Learning Collaborative (GLC) has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.00 AAPA Category 1 CME credit(s). PAs should claim only the credit commensurate with the extent of their participation in the activity.
Global Learning Collaborative (GLC) designates this activity for a maximum of 1.00 contact hour(s)/0.10 CEUs of pharmacy continuing education credit.
The Universal Activity Number (UAN) for this program is JA0006235-0000-26-142-H01-P. This learning activity is knowledge-based. Upon successful completion of the activity, continuing education credit will be electronically submitted to the National Association of Boards of Pharmacy (NABP). Pharmacists with questions may contact NABP Customer Service at custserv@nabp.net.Provider(s)/Educational Partner(s)
Our ultimate goal is to improve the care being delivered to patients, and our high-quality, evidence-based CME initiatives reflect our dedication to the creation and execution of excellence and are the product of shared research, knowledge, and clinical practice skills across the healthcare continuum.Commercial Support
This activity is supported by an independent educational grant from MannKind Corporation.
Disclaimer
The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Medtelligence. This presentation is not intended to define an exclusive course of patient management; the participant should use his/her clinical judgment, knowledge, experience, and diagnostic skills in applying or adopting for professional use any of the information provided herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Links to other sites may be provided as additional sources of information.
Reproduction Prohibited
Reproduction of this material is not permitted without written permission from the copyright owner.System Requirements
- Supported Browsers (2 most recent versions):
- Google Chrome for Windows, Mac OS, iOS, and Android
- Apple Safari for Mac OS and iOS
- Mozilla Firefox for Windows, Mac OS, iOS, and Android
- Microsoft Edge for Windows
- Recommended Internet Speed: 5Mbps+
Publication Dates
Release Date:
Expiration Date: Ongoing Program - Expiration date will be posted when all episodes are published.
