Acute Decompensated Heart Failure Clinical Trial
Official title:
Does Serial Ultrasonographic Assessment for Extravascular Lung Water and IVC Measurement Affect Outcomes in Inpatient Heart Failure Management?
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.
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.
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