Does Ultrasound Assessment for Extravascular Lung Water and IVC Measurement Affect Outcomes in Inpatient Heart Failure Management?

  • STATUS
    Recruiting
  • End date
    Jul 1, 2021
  • participants needed
    400
  • sponsor
    Riverside University Health System Medical Center
Updated on 25 January 2021
diuretics
diuretic therapy

Summary

This study evaluates daily POCUS/FCU exams on patients admitted for acute decompensated heart failure with primary end point of acute kidney injury while in hospital.

Description

Patients with admitted to hospital with Acute Decompensated Heart failure (ADHF) suffer a significant morbidity and premature mortality. Administration of intravenous (IV) diuretics is largely guided by clinical judgment based on physical exam, net fluid measurement, changes in daily weights and chest x-ray findings. The key objective is to promote adequate diuresis while improving symptoms, without compromising renal function. Laboratory tests demonstrating hemo-concentration, increasing BUN, and increasing creatinine have been proposed as positive prognostic indicators in patients receiving IV diuretic therapy but these methods suffer from inadequate predictive value. Observational studies have identified worsening renal failure (WRF) in patients admitted for heart failure as an important clinical entity associated with worsening clinical outcomes.

Point of care Ultrasound (POCUS) has the potential to fill an unmet need for monitoring patients recieving IV diuretic therapy. POCUS provides clinicians with immediate diagnostic information obtained and interpreted at bedside that can augment and enhance the physical examination. Numerous studies have examined POCUS assessment of pulmonary edema and measurement of the Inferior Vena Cava (IVC) to estimate hemodynamic parameters for patients with acute decompensated heart failure (ADHF). No study to date has examined POCUS effect on clinical outcomes.

Details
Condition Acute Decompensated Heart Failure
Treatment Daily pocus exam
Clinical Study IdentifierNCT04436718
SponsorRiverside University Health System Medical Center
Last Modified on25 January 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Is your age between 18 yrs and 95 yrs?
Gender: Male or Female
Do you have Acute Decompensated Heart Failure?
Do you have any of these conditions: Do you have Acute Decompensated Heart Failure??
Age >18 admitted for acute decompensated heart failure exacerbation as primary admission diagnosis from Emergency department to General Medicine ward that are administered diuretic therapy expected to be admitted for two days or more

Exclusion Criteria

Decline consent for study
If admitted and research team not available for consent and initial evaluation prior within 6 hours of first diuretic administration
Patients in whom diuretics will not be utilized (i.e. anuric, ESRD on HD)
Inability to assess IVC (surgical anatomy, body habitus, Ileus, etc.)
Patients admitted to ICU
Patients currently on positive pressure ventilation (BiPAP)
Patients discharged from the emergency department
Patients discharged prior to evaluation by the POCUS team
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