Clinical trial NCT04633629: LUS in Acute Heart Failure Therapeutic Adaptation
Official title: Interest of Lung Ultrasound (LUS) in Therapeutic Adaptation of Patients Hospitalized in Medical Department for Acute Heart Failure (AHF).
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Acute Heart Failure
Pulmonary Congestion
Keywords: Lung Ultrasound
Diuretics
Medical department
Lead sponsor: University Hospital, Grenoble
Sponsor class: OTHER
First posted: 2020-11-18
Enrollment: 94
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients aged over 18, hospitalized from the emergency department in the medical department for acute heart failure.

Brief summary: Evaluate lung ultrasound aspect according to diuretics dosage evolution in patients hospitalized for acute heart failure.

Detailed description: EPPICA is an observational and prospective cohort study. The study goal is to evaluate LUS aspect evolution according to diuretics dosage in patients hospitalized for acute heart failure.

Eligibility criteria: Inclusion Criteria:

* Acute heart failure diagnosed by a senior physician in the medical department, with a confirmation of a second senior physician.
* Hospitalised in the medical department.
* No objection from the patient of his trusted person.

Exclusion Criteria:

* Administrative supervision or deprived of their liberty
* Pulmonary conditions distracting lung ultrasound (pneumonectomy, pulmonary fibrosis)
* Chronically dialysed

Primary outcomes:
measure: Lung ultrasound aspect according to diuretics dosage evolution.
timeFrame: LUS will be performed daily during the whole hospitalisation length (on average 7 days).
Secondary outcomes:
measure: Lung ultrasound aspect according to clinical signs of acute heart failure (crackling auscultation or lower limbs edema)
timeFrame: LUS and clinical examination will be performed daily during the whole hospitalisation length (on average 7 days).
measure: Lung ultrasound aspect according to acute kidney injury (based on plasmatic creatinine levels).
timeFrame: LUS will be performed daily during the whole hospitalisation length (on average 7 days). Plasmatic creatinine measure will be performed at least weekly.
measure: Lung ultrasound aspect according to early prognosis (re-hospitalisation or mortality within 30 days after discharge)
timeFrame: LUS will be performed daily during the whole hospitalisation length (on average 7 days). Patient will be called 30 days after discharge.
measure: Feasibility of daily LUS in medical department.
timeFrame: LUS will be performed daily during the whole hospitalisation length (on average 7 days).
measure: Interest of LUS compared to clinical examination at discharge.
timeFrame: LUS and clinical examination will be performed daily during the whole hospitalisation length (on average 7 days).
Other outcomes:
Locations:
Study officials:
affiliation: University Hospital, Grenoble
name: Perrine Dumanoir, Doctor
role: PRINCIPAL_INVESTIGATOR
References:
citation: Ohman J, Harjola VP, Karjalainen P, Lassus J. Focused echocardiography and lung ultrasound protocol for guiding treatment in acute heart failure. ESC Heart Fail. 2018 Feb;5(1):120-128. doi: 10.1002/ehf2.12208. Epub 2017 Sep 28.
citation: Coiro S, Rossignol P, Ambrosio G, Carluccio E, Alunni G, Murrone A, Tritto I, Zannad F, Girerd N. Prognostic value of residual pulmonary congestion at discharge assessed by lung ultrasound imaging in heart failure. Eur J Heart Fail. 2015 Nov;17(11):1172-81. doi: 10.1002/ejhf.344. Epub 2015 Sep 29.
citation: Gargani L, Pang PS, Frassi F, Miglioranza MH, Dini FL, Landi P, Picano E. Persistent pulmonary congestion before discharge predicts rehospitalization in heart failure: a lung ultrasound study. Cardiovasc Ultrasound. 2015 Sep 4;13:40. doi: 10.1186/s12947-015-0033-4.
citation: Platz E, Merz AA, Jhund PS, Vazir A, Campbell R, McMurray JJ. Dynamic changes and prognostic value of pulmonary congestion by lung ultrasound in acute and chronic heart failure: a systematic review. Eur J Heart Fail. 2017 Sep;19(9):1154-1163. doi: 10.1002/ejhf.839. Epub 2017 May 30.
citation: Volpicelli G, Caramello V, Cardinale L, Mussa A, Bar F, Frascisco MF. Bedside ultrasound of the lung for the monitoring of acute decompensated heart failure. Am J Emerg Med. 2008 Jun;26(5):585-91. doi: 10.1016/j.ajem.2007.09.014.
citation: Rusu DM, Siriopol I, Grigoras I, Blaj M, Ciumanghel AI, Siriopol D, Nistor I, Onofriescu M, Sandu G, Cobzaru B, Scripcariu DV, Diaconu O, Covic AC. Lung Ultrasound Guided Fluid Management Protocol for the Critically Ill Patient: study protocol for a multi-centre randomized controlled trial. Trials. 2019 Apr 25;20(1):236. doi: 10.1186/s13063-019-3345-0.