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Point-of-Care Ultrasound-Guided Diuresis for Acute Decompensated Heart Failure to Reduce 30-Day Readmissions and Acute Kidney Injury (POCUSHF-GD)
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.
Details
| Lead sponsor | University of Pittsburgh |
|---|---|
| Phase | NA |
| Status | RECRUITING |
| Enrolment | 588 |
| Start date | 2025-06-29 |
| Completion | 2026-12 |
Conditions
- Heart Decompensation, Acute
- Acute Kidney Injuries
Interventions
- Furosemide (Standard Diuretic) Treatment
- POCUS-Assessed Diuretic Management
Primary outcomes
- 30-Day Readmission Rate in Acute Decompensated Heart Failure (ADHF) Patients — From date of hospital discharge until date of first readmission for heart failure or 30 days post-discharge, whichever comes first.
The percentage of participants readmitted to the hospital within 30 days of discharge for heart failure-related issues. The outcome compares the readmission rates between the POCUS-assessed diuretic management group and the standard care group. - Incidence of Acute Kidney Injury (AKI) — From baseline to hospital discharge and up to 30 days post-discharge (if readmitted).
The percentage of participants who develop acute kidney injury (AKI) during hospitalization or within 30 days post-discharge (if readmitted). Definition: AKI will be defined using the Acute Kidney Injury Network (AKIN) criteria: * Increase in serum creatinine by ≥0.3 mg/dL within 48 hours OR * Increase in serum creatinine by ≥50% from baseline OR * Reduced urine output (\<0.5 mL/kg/hr for ≥6 hours). Outcome Type: Binary (Yes/No)
Countries
United States