AUTHOR=Collado Macián Carlos , Pujol Pocull David , Dominguez Fernando , López-Azor Juan Carlos , Garcia-Pavia Pablo , Nuñez Julio , Cobo Marcos Marta 

TITLE=Case report: Alternative approach for management of refractory volume overload in heart failure: usefulness of venous leg compression

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1230980

DOI=10.3389/fcvm.2023.1230980

ISSN=2297-055X

ABSTRACT=Background: Management of patients with refractory congestion, is one of the most important challenges in the field of heart failure (HF). Diuretic therapy remains the most widely used therapy to achieve euvolemia. However, some patients experience fluid overload despite the use of high-dose diuretics and new strategies to overcome diuretic resistance are needed.

Case Summary: We report an 85-year-old male patient admitted for decompensated HF with persistent tissue fluid overload (peripheral edema) for more than two weeks despite a high dose of intravenous furosemide with the combination of other diuretics. At this point, we performed leg venous compression using elastic bandages for three days. After 72 hours, edema disappeared, and additional weight loss was achieved (1 kg/day). No side effects were observed and the patient was discharged home euvolemic.

Conclusion: Venous leg compression is an alternative therapy in patients with persistent fluid overload resistant to diuretics.