RecruitingNot ApplicableNCT06921603

POCUS-Guided Diuresis for Decompensated Heart Failure

Point-of-Care Ultrasound-Guided Diuresis for Acute Decompensated Heart Failure to Reduce 30-Day Readmissions and Acute Kidney Injury


Sponsor

University of Pittsburgh

Enrollment

588 participants

Start Date

Jun 29, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

Heart failure occurs when the heart cannot pump blood effectively, leading to fluid buildup in the body. This can cause problems such as difficulty breathing, swelling, and extreme tiredness. In severe cases, these symptoms worsen to the point where hospitalization is required. Unfortunately, many patients with severe heart failure are readmitted to the hospital within 30 days after discharge, which is both physically and emotionally challenging for patients and places a significant financial burden on individuals and the healthcare system. Although symptoms such as difficulty breathing and swelling may improve during the hospital stay, some patients are discharged with excess fluid remaining in their bodies. This retained fluid often causes symptoms to worsen, leading to subsequent hospital readmissions. Inadequate management of fluid levels can also harm the kidneys, further complicating the patient's condition. This study aims to improve care for heart failure patients by utilizing a simple, non-invasive tool to assess fluid levels more accurately at the bedside. The tool measures the size of a large blood vessel in the neck, providing key information about the pressure inside the heart. This information enables clinicians to determine the appropriate amount of medication needed to remove just the right amount of fluid. Properly managing fluid levels can help prevent kidney damage and improve overall patient outcomes. The primary goal of this study is to evaluate whether this tool can reduce the number of patients readmitted to the hospital within 30 days of discharge. A secondary goal is to determine whether the tool can help protect kidney function by allowing for better fluid management. If successful, this approach has the potential to help heart failure patients stay healthier, reduce hospital visits, and lower healthcare costs.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is testing whether using bedside ultrasound (a portable scanner) to guide how doctors give diuretics (water pills) to patients with acute heart failure leads to better outcomes than standard care. Heart failure causes fluid buildup, and removing the right amount requires careful monitoring. **You may be eligible if...** - You are 18 or older - You have been diagnosed with acute decompensated heart failure (your heart has suddenly worsened and fluid has built up) - You are planned to receive intravenous diuretics - A bedside ultrasound of your neck vein shows a reading indicating fluid overload **You may NOT be eligible if...** - You have a Left Ventricular Assist Device (LVAD — a mechanical heart pump) - You have physical features that make ultrasound measurement of neck veins unreliable - You are in shock or critically unstable Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

OTHERFurosemide (Standard Diuretic) Treatment

Participants in this group will receive intravenous furosemide as part of their routine care, based on clinical assessments including symptoms, physical examination. Daily POCUS imaging will be performed for research purposes; however, the findings will not be shared with the treating clinical team. Fluid management decisions and discharge planning will follow usual care protocols, without additional imaging-based guidance.

OTHERPOCUS-Assessed Diuretic Management

POCUS will be used to provide objective, non-invasive assessments of fluid status by measuring right internal jugular vein (RIJV) cross-sectional area (CSA) and calculating the Distensibility Index (DI). This information will be shared with the treating clinical team as an additional tool for fluid management. However, all final decisions regarding diuretic therapy will be made at the discretion of the treating physicians.


Locations(5)

UPMC East

Pittsburgh, Pennsylvania, United States

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

UPMC Presbyterian

Pittsburgh, Pennsylvania, United States

UPMC Mercy

Pittsburgh, Pennsylvania, United States

UPMC Shadyside

Pittsburgh, Pennsylvania, United States

View Full Details on ClinicalTrials.gov

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NCT06921603


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