RECRUITING

POCUS-Guided Diuresis for Decompensated Heart Failure

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

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.

Official Title

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

Quick Facts

Study Start:2025-06-29
Study Completion:2026-12
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT06921603

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. Age: Patients must be 18 years or older.
  2. 2. Diagnosis: Must have a confirmed diagnosis of acute decompensated heart failure (ADHF).
  3. 3. Treatment Plan: Patients must be planned for treatment with intravenous (IV) diuretics.
  4. 4. POCUS Measurement: Must have an abnormal right internal jugular vein (RIJV) distensibility index (DI) of \<66% on point-of-care ultrasound (POCUS) at the time of admission.
  1. 1. Left Ventricular Assist Devices (LVAD): Patients with LVADs will be excluded due to their unique hemodynamics, which may interfere with study assessments.
  2. 2. Anatomical Incompatibilities: Excludes patients with RIJV or superior vena cava thrombus, congenital heart disease, or severe tricuspid regurgitation, as these conditions may impair accurate POCUS measurements.
  3. 3. Cardiomyopathy: Patients with hypertrophic or infiltrative cardiomyopathy will be excluded.
  4. 4. End-of-Life Care: Patients receiving hospice care or comfort measures only will not be included in the study.
  5. 5. Advanced Cancer: Patients with metastatic cancer will be excluded.
  6. 6. Severe Liver Dysfunction: Patients with a MELD-Na score greater than 20, indicating severe liver dysfunction, will be excluded.
  7. 7. End stage chronic kidney disease
  8. 8. Inability to Provide Consent: Patients who are unable to provide informed consent, due to cognitive impairment or other reasons, will not be eligible.
  9. 9. Inotropic Support: Patients requiring inotropic support at the time of enrollment will be excluded, as they represent a more severe heart failure profile that may not be suitable for this trial.

Contacts and Locations

Study Contact

John J Pacella, MD
CONTACT
4127805529
pacellajj@upmc.edu
Benay Ozbay, MD
CONTACT
4124502774
benayozbay@hotmail.com

Principal Investigator

John J Pacella, MD
PRINCIPAL_INVESTIGATOR
University of Pittsburgh Medical Center (UPMC)

Study Locations (Sites)

University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, 15213
United States
UPMC Presbyterian
Pittsburgh, Pennsylvania, 15213
United States

Collaborators and Investigators

Sponsor: University of Pittsburgh

  • John J Pacella, MD, PRINCIPAL_INVESTIGATOR, University of Pittsburgh Medical Center (UPMC)

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2025-06-29
Study Completion Date2026-12

Study Record Updates

Study Start Date2025-06-29
Study Completion Date2026-12

Terms related to this study

Keywords Provided by Researchers

  • heart failure
  • point-of-care-ultrasound
  • readmission
  • acute kidney injury

Additional Relevant MeSH Terms

  • Heart Decompensation, Acute
  • Acute Kidney Injuries