Using Bedside Ultrasound to Guide Fluid Removal for Adults with Acute Heart Failure to Reduce Hospital Readmissions and Kidney Injury

What This Trial Is About

Heart failure happens when the heart struggles to pump blood effectively, causing fluid buildup that leads to symptoms like trouble breathing, swelling, and fatigue. This condition often results in hospital stays, and many patients are readmitted within 30 days after leaving. This study evaluates a new, simple bedside tool that uses ultrasound to measure fluid levels more accurately in patients with acute decompensated heart failure, aiming to reduce hospital readmissions and protect kidney function. The study compares two groups of patients hospitalized with acute decompensated heart failure. One group will have their fluid status monitored daily with point-of-care ultrasound POCUS, which measures the size and flexibility of a large vein in the neck to estimate heart pressure and guide diuretic medication doses. The other group will receive standard intravenous diuretic treatment based on usual clinical assessments, with ultrasound performed only for research and not guiding care. Both groups receive intravenous furosemide, a common diuretic, during their hospital stay. Participants will be closely monitored from admission through discharge and up to 30 days after leaving the hospital. Assessments include daily ultrasound scans to measure fluid status, kidney function tests, and tracking of hospital readmissions and mortality. The study will also evaluate how well clinicians follow ultrasound-guided recommendations and the length of hospital stays. Overall, this research aims to improve fluid management, reduce kidney injury, and decrease the chance of patients needing to return to the hospital soon after discharge.

POCUS-Guided Diuresis for Decompensated Heart Failure