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B-lines Lung Ultrasound Guided ED Management of Acute Heart Failure (BLUSHED-AHF)

B 线肺部超声引导急性心力衰竭的 ED 治疗 (BLUSHED-AHF)

基本信息

批准号：
9299462
负责人：
Peter S Pang
金额：
$ 40.02万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-04-17 至 2019-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9299462
关键词：
Accident and Emergency department Acute Algorithms American Blood Pressure Breathing Caring Chronic Congestive Diagnosis Diuretics Effectiveness Emergency Department Physician Emergency Department patient Enrollment Environmental air flow Extravascular Lung Water Failure Future Goals Guidelines Heart failure Hematocrit procedure Hemoglobin Heterogeneity Hospitalization Hospitals Hour Intravenous Learning Leg Lung Measurement Measures Medication Management Morbidity - disease rate Nitrates Outcome Patient Care Patients Pharmaceutical Preparations Pilot Projects Prognostic Marker Protocols documentation Randomized Recording of previous events Recruitment Activity Reproducibility Research Design Residual state Resolution Safety Site Swelling Techniques Testing Time Treatment Failure Ultrasonography Variant Water Weight Gain base diagnostic accuracy evidence base improved improved outcome mortality novel strategies novel therapeutics patient population pilot trial targeted treatment treatment as usual

项目摘要

Title: B-lines Lung Ultrasound Guided ED Management of Acute Heart Failure (BLUSHED-AHF) ABSTRACT 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. We 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 are a measure of congestion. This simple, easily learned technique has excellent reliability and reproducibility. We 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.

标题：急性心力衰竭（BLUSHED-AHF）的B线肺部超声引导艾德管理摘要近80%的急性心力衰竭（AHF）患者入院时在急诊室接受初步治疗部门（艾德）。一旦入院，在出院后30天内，27%的患者再次住院或死亡。尝试用新的疗法来改善结果都失败了。现有AHF治疗的证据差：目前没有已知的AHF治疗可以改善结局。艾德治疗在很大程度上是相同的 40年前的今天。充血，如呼吸困难，体重增加和腿部肿胀，是主要的患者因AHF而住院的原因。治疗充血是AHF的基石管理然而，一半的AHF患者离开医院时没有充分缓解充血。我们提出了一种新艾德环境中积极缓解患者充血的方法：肺部超声引导、方案驱动、AHF 管理LUS B线是血管外肺水（EVLW）的量度。在AHF的设置中，LUS是一种衡量拥挤程度的方法。这种简单易学的技术具有出色的可靠性和再现性。我们假设护理策略将优于常规护理。目前，常规护理主要是经验主义本研究将为艾德急性心力衰竭的治疗提供更多的证据。这项试点研究，如果成功，将导致一项结果试验，检查艾德AHF护理策略是否增加生存天数和医院外的病人。