RecruitingNot ApplicableNCT06465498

Investigating ACute HeArt FailuRe Decongestion Guided by Lung UltraSonography

Investigating ACute HeArt FailuRe Decongestion Guided by Lung UltraSonography (IcarUS) : a Randomized Controlled Trial

Sponsor

Antonio Leidi

Enrollment

222 participants

Start Date

Oct 22, 2024

Study Type

INTERVENTIONAL

Conditions

Acute Heart Failure

Summary

The goal of this clinical trial is to investigate whether a lung ultrasonography (LUS)-guided decongestion strategy in adults hospitalized for acute heart failure (AHF) can improve patient-centered outcomes. The main questions it aims to answer are: * Does this strategy shorten the length of stay and reduce early hospital readmissions? * Does this strategy improve patients' symptoms and quality of life ? Researchers will compare LUS to physical examination (PE).

Eligibility

Min Age: 18 Years

Inclusion Criteria4

≥ 18 years old
Planned or actual admission to intermediate care units, general internal medical or cardiology wards
Diagnosis of congestive AHF on admission chart (primary or secondary diagnosis)
Raised value of N terminal-pro-brain natriuretic peptide (≥1000 ng/l).

Exclusion Criteria7

Known isolated right heart failure
Systolic blood pressure \<90 mmHg, mean arterial pressure \<65 mmHg at the moment of inclusion
The following conditions mimicking lung cardiogenic oedema on LUS if known at inclusion and documented: Interstitial lung disease, lung cancer or metastasis, acute respiratory distress syndrome, pulmonary contusion
Known virologically confirmed SARS-CoV-2 pneumonia in the preceding 3 months
Unwillingness to give consent
Subjects who are pregnant or breastfeeding
Hospitalisation for palliative care and probable end-life within 30 days

Interventions

PROCEDURELUS decongestive strategy

LUS results are documented in the electronic case report form (eCRF) and converted into a common score ranging from absence of congestion to severe congestion. This generic congestion score will be communicated to the treating physician by the research personnel, along with a proposal to step-up, maintain, or step-down the decongestive therapy.

PROCEDUREPE decongestive strategy

PE results are documented in the eCRF and converted into a common score ranging from absence of congestion to severe congestion. This generic congestion score will be communicated to the treating physician by the research personnel, along with a proposal to step-up, maintain, or step-down the decongestive therapy.