Characteristics of included studies.

Background
Heart failure (HF) significantly impacts healthcare systems due to high rates of hospital bed utilization and readmission rates. Chronic HF often leads to frequent hospitalizations due to recurrent exacerbations and a decline in patient health status. Intravenous (IV) diuretic administration is essential for treating worsening HF. Emerging strategies include home-based IV diuretic therapy administration; however, limited practical implementation guidance is available. This scoping review aims to summarize the literature on home IV diuretic administration for HF patients, focusing on the interventions’ characteristics, and facilitators and barriers to its implementation.
Methods
This review followed the scoping review framework proposed by Arksey and O’Malley and PRIMSA-ScR. A comprehensive search was conducted across six databases (CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsychINFO and Scopus) and grey literature to identify English studies from inception to April 13, 2024. Two independent reviewers screened articles and resources for inclusion and data was extracted using a form created by the authors in Covidence.
Results
The search yielded 2,049 results, with nine studies meeting the inclusion criteria. Studies varied in design, including feasibility, pilot, observational, and pre/post-intervention evaluations. The majority were conducted in European countries, with sample sizes ranging from 12 to 96 patients receiving home IV diuretics for HF. Key implementation challenges include appropriate patient selection, IV cannulation competency of healthcare providers, and multi-disciplinary and multi-agency collaboration.
Conclusions
Evidence on home IV diuretic administration practices for HF management remains limited. However, this scoping review suggests that commonalities across studies could form the basis for developing standard protocols in outpatient settings. Despite the lack of formal evidence-based guidelines, the findings also suggest that tailored, community-specific approaches and safe infusion guidance documents could enhance the efficacy and scalability of home IV diuretic therapy. Future research should focus on refining these strategies and exploring diuretic escalation methods beyond traditional acute care administration to optimize patient outcomes.

背景
心力衰竭（Heart failure, HF）因居高不下的病床占用率与再入院率，对全球医疗保健系统造成显著负担。慢性心力衰竭患者常因病情反复急性加重及健康状况恶化，频繁住院治疗。静脉（Intravenous, IV）利尿剂给药是治疗病情恶化型心力衰竭的关键手段。当前新兴治疗策略包含居家静脉利尿剂给药，但现有实用实施指南较为匮乏。本范围综述旨在系统梳理针对心力衰竭患者居家静脉利尿剂给药的相关文献，重点聚焦该干预措施的特征、实施促进因素与阻碍因素。

方法
本综述遵循Arksey与O’Malley提出的范围综述框架及PRIMSA-ScR规范。研究团队于2024年4月13日前，全面检索了CINAHL、Cochrane图书馆、EMBASE、MEDLINE、PsychINFO及Scopus共6个数据库及灰色文献，筛选收录截至彼时的英文研究。由两名独立评审员完成文献与资源的纳入筛查，并通过作者在Covidence平台创建的专用表单提取研究数据。

结果
本次检索共获取2049条文献记录，最终9项研究符合纳入标准。研究设计类型多样，涵盖可行性研究、预试验、观察性研究及干预前后评估。多数研究在欧洲国家开展，样本量介于12至96名接受居家静脉利尿剂治疗的心力衰竭患者之间。核心实施挑战包括：合理的患者遴选标准、医疗人员的静脉置管操作能力，以及多学科、多机构协作障碍。

结论
目前针对心力衰竭管理中居家静脉利尿剂给药实践的相关证据仍较为有限。但本范围综述显示，不同研究间存在共通特征，可作为门诊场景下标准化治疗方案制定的基础。尽管缺乏正式的循证指南，研究结果亦表明，定制化的社区专属方案及安全输注指导文件，可有效提升居家静脉利尿剂治疗的有效性与规模化应用潜力。未来研究应聚焦优化此类策略，并探索超越传统急诊给药模式的利尿剂剂量递增方案，以进一步优化患者临床结局。