Stepwise water‑pill (diuretic) plan versus usual care for people with acute heart failure in the emergency room
Official title: A Randomized Trial of Protocolized Diuretic Therapy Compared to Standard Care in Emergency Department Patients with Acute Heart Failure
Funded at Vanderbilt University Medical Center · NIH-11171538 · Data updated 2026-11-12
This project compares a step-by-step plan for giving water pills to usual care to help people with sudden worsening heart failure in the emergency room remove extra fluid and feel better sooner.
Quick facts
| Grant type | NIH-funded research |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Vanderbilt University Medical Center NIH-funded |
| Lab location | 1 site (Nashville, United States) |
| Project start | September 1, 2021 |
| Project end | August 31, 2026 |
| Funding year | 2025 |
| Award (this year) | $782,404 |
| NIH project number | 5R33HL155810-05 |
| Project ID | NIH-11171538 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults who present to the emergency department with acute worsening heart failure and who require intravenous loop diuretics would be the main candidates for this protocol.
✕Less likely to help
People without heart failure, those who do not need IV diuretics, patients on chronic dialysis or with contraindications to diuretics, or those who are hemodynamically unstable may not be eligible or likely to benefit.
What this research studies
If you come to the emergency room with sudden worsening heart failure and need IV diuretics, you could be randomly assigned to follow a standardized diuretic dosing plan or to receive the usual care your doctors would pick. Doctors will closely track your urine output, weight, symptoms like breathlessness, and routine blood tests while in the hospital. The team will use those measures to guide diuretic dosing in the protocol arm and compare how well patients are decongested, how long they stay in the hospital, and whether they return to the hospital after discharge. The goal is to find whether a clear, stepped approach leads to less leftover fluid and fewer complications than current varied practices.
Why it matters
Potential benefit: If successful, the approach could reduce leftover fluid in the body, shorten hospital stays, and lower readmissions for people hospitalized with acute heart failure.
How similar studies have gone: Previous trials focused on initial IV diuretic doses and did not identify a single best approach, so a protocolized, response‑guided strategy remains relatively new and unproven.
Where this research is happening
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Vanderbilt University Medical Center
Nashville, United States Active
Researchers
- Principal investigator: Collins, Sean Patrick — Vanderbilt University Medical Center
- Study coordinator: Collins, Sean Patrick
Related research
Other NIH-funded projects on the same topics.
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Using AI to monitor lung fluid in sudden (acute) heart failure in the ER
This project will use an AI-assisted lung ultrasound method to track lung congestion in people who come to the emergency department with acute heart failure.
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Using AI to monitor fluid buildup in patients with acute heart failure in emergency settings
This study is looking at how using a special ultrasound tool can help doctors better check for fluid buildup in the lungs of patients with acute heart failure in emergency rooms, so they can get the right treatment faster and leave the hospital feeling better.
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Improving hospitalization decisions for emergency patients with heart failure
This study is looking at how to help doctors decide if patients with acute heart failure should be admitted to the hospital or can safely recover at home, by considering important factors about their health and personal situations.
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Understanding changes in kidney function during acute heart failure
This study is looking into how heart failure affects kidney function, especially in veterans, to find specific markers that can help doctors understand the different reasons for kidney problems during heart failure, ultimately aiming to improve diagnosis and treatment for patients.
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Comparing two approaches to diuretic therapy for patients with acute heart failure in the emergency department
This study is looking at whether a special plan for using diuretics can help people with acute heart failure feel better and recover faster in the emergency department compared to the usual care they receive.
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Improving how we diagnose acute heart failure
This study is working on a new way to help doctors more accurately diagnose acute heart failure in patients who come to the emergency room with symptoms like shortness of breath, so they can get the right treatment faster and feel better sooner.
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.