B-lines Lung Ultrasound Guided ED Management of Acute Heart Failure Pilot Trial
Status:
Completed
Trial end date:
2019-06-20
Target enrollment:
Participant gender:
Summary
Nearly 80% of acute heart failure (AHF) patients admitted to the hospital are initially
treated in the emergency department (ED). Once admitted, within 30 days post-discharge, 27%
of patients are re-hospitalized or die. Attempts to improve outcomes with novel therapies
have all failed. The evidence for existing AHF therapies are poor: No currently used AHF
treatment is known to improve outcomes. ED treatment is largely the same today as 40 years
ago. Congestion, such as difficulty breathing, weight gain, and leg swelling, is the primary
reason why patients present to the hospital for AHF. Treating congestion is the cornerstone
of AHF management. Yet half of all AHF patients leave the hospital inadequately decongested.
The investigators propose a novel approach to aggressively decongest patients in the ED
setting: lung ultrasound guided, protocol driven, AHF management. LUS B-lines are a measure
of extra-vascular lung water (EVLW). In the setting of AHF, LUS B-lines are a measure of
congestion. This simple, easily learned technique has excellent reliability and
reproducibility. The investigators hypothesize that a strategy-of-care will outperform usual
care. At the present time, usual care is largely empirical. This study will improve the
evidence base for ED AHF management. This proposed pilot study, if successful, will lead to
an outcome trial examining whether an ED AHF strategy-of-care increases days alive and out of
the hospital for patients.
Phase:
Phase 2
Details
Lead Sponsor:
Indiana University
Collaborators:
Case Western Reserve University Inova Fairfax Hospital Vanderbilt University Wayne State University