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

标题：B线肺超声引导下急诊介入治疗急性心力衰竭(红心衰) 摘要 在入院的急性心力衰竭(AHF)患者中，近80%的患者最初是在急诊接受治疗的 部门(ED)。一旦入院，在出院后30天内，27%的患者会再次住院或死亡。 试图用新的疗法来改善结果的尝试都失败了。现有AHF疗法的证据 都很差：目前还没有已知的AHF治疗方法可以改善结果。勃起功能障碍的治疗大体相同 今天和40年前一样。充血，如呼吸困难、体重增加和腿部肿胀，是主要的 AHF患者来医院就诊的原因。治理拥堵是AHF的基石 管理层。然而，所有AHF患者中有一半离开医院时没有得到充分的缓解。我们提议写一部小说 在急诊室中积极缓解患者充血的方法：肺超声引导、方案驱动、AHF 管理层。LUS B线是衡量血管外肺水(EVLW)的指标。在AHF的设置中，LU是 这是拥堵的一种衡量标准。这种简单易学的技术具有极好的可靠性和重复性。我们 假设一种护理策略会比通常的护理效果好。目前，通常的护理主要是 经验主义。这项研究将为ED AHF的治疗提供更多的证据。这项拟议的试点研究，如果 成功，将导致一项结果试验，检查ED AHF护理策略是否增加存活天数 和出院的病人。

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.