POCUS-Guided Diuresis for Decompensated Heart Failure

Launched by UNIVERSITY OF PITTSBURGH · Apr 2, 2025

Keywords

ClinConnect Summary

This clinical trial is focused on improving care for patients with heart failure, particularly those who are hospitalized due to severe fluid buildup in their bodies. The study aims to use a special, non-invasive tool that helps doctors measure fluid levels more accurately at the bedside. By understanding how much fluid is in the body and adjusting medications accordingly, the goal is to help patients recover better and reduce the chances of being readmitted to the hospital within 30 days after discharge. This is important because many patients experience worsening symptoms and need to return to the hospital, which can be difficult both physically and financially.

To be eligible for this study, participants must be at least 18 years old and diagnosed with acute decompensated heart failure, meaning their heart is struggling to pump blood effectively. They also need to be planned for treatment with intravenous diuretics, which are medications that help remove excess fluid. However, some individuals will not qualify, such as those with certain heart conditions, severe liver issues, or those in hospice care. If you or a loved one are interested in participating, you can expect to receive careful monitoring and support throughout the trial, with the hope that this new approach will lead to better health outcomes and fewer hospital visits.

Gender

ALL

Eligibility criteria

• List the inclusion criteria:
• • 1. Age: Patients must be 18 years or older.
• • 2. Diagnosis: Must have a confirmed diagnosis of acute decompensated heart failure (ADHF).
• • 3. Treatment Plan: Patients must be planned for treatment with intravenous (IV) diuretics.
• • 4. POCUS Measurement: Must have an abnormal right internal jugular vein (RIJV) distensibility index (DI) of \<66% on point-of-care ultrasound (POCUS) at the time of admission.
• • These criteria ensure that participants are appropriately selected for the study and are likely to benefit from POCUS-guided diuretic management.
• List the exclusion criteria:
• • 1. Left Ventricular Assist Devices (LVAD): Patients with LVADs will be excluded due to their unique hemodynamics, which may interfere with study assessments.
• • 2. Anatomical Incompatibilities: Excludes patients with RIJV or superior vena cava thrombus, congenital heart disease, or severe tricuspid regurgitation, as these conditions may impair accurate POCUS measurements.
• • 3. Cardiomyopathy: Patients with hypertrophic or infiltrative cardiomyopathy will be excluded.
• • 4. End-of-Life Care: Patients receiving hospice care or comfort measures only will not be included in the study.
• • 5. Advanced Cancer: Patients with metastatic cancer will be excluded.
• • 6. Severe Liver Dysfunction: Patients with a MELD-Na score greater than 20, indicating severe liver dysfunction, will be excluded.
• • 7. End stage chronic kidney disease
• • 8. Inability to Provide Consent: Patients who are unable to provide informed consent, due to cognitive impairment or other reasons, will not be eligible.
• • 9. Inotropic Support: Patients requiring inotropic support at the time of enrollment will be excluded, as they represent a more severe heart failure profile that may not be suitable for this trial.