Using intra‑abdominal pressure and bedside ultrasound to guide decongestive treatment in heart failure

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a randomized, multicenter Phase 3 trial enrolling adults admitted with acute heart failure and clinical signs of congestion. Participants must have elevated natriuretic peptides and a urinary catheter to allow intra‑abdominal pressure measurement, and they are randomized to diuretic dosing guided by intra‑abdominal pressure plus point‑of‑care ultrasound versus conventional care. The intervention uses serial intra‑abdominal pressure readings and focused ultrasound findings to tailor intravenous loop diuretic (furosemide) dosing during the hospital stay. The trial is led by Instituto de Investigación Sanitaria Aragón with enrollment at Hospital Clínico Universitario Lozano Blesa in Zaragoza, Spain.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Men or women over 18 years of age.
* Diagnosis of heart failure (HF) based on the latest HF guidelines published in 2022.
* N-terminal pro b-type natriuretic peptide (NT-proBNP) \> 1000 pg/mL or Brain Natriuretic Peptide (BNP) \> 250 pg/mL.
* Placement of a urinary catheter to allow for the measurement of intra-abdominal pressure.
* Intravascular or mixed congestion pattern, defined as the presence of one or more clinical signs of congestion (edema, ascites, and/or pleural effusion).
* Signed informed consent

Exclusion Criteria:

* Patient with a stay in the Internal Medicine department \> 24 hours.
* Absence of sufficient clinical congestion (ADVOR score = 0 at the time of randomization).
* Patient\'s refusal to participate in the clinical trial.
* Inability or contraindication for urinary catheter placement.
* Systolic blood pressure at admission \< 100 mmHg.
* Heart rate at admission \> 170 beats per minute (bpm).
* Cardiogenic shock.
* Acute myocardial ischemia.
* Patients receiving renal replacement therapy (ultrafiltration or peritoneal dialysis).
* Kidney transplant recipients.
* Serum hemoglobin \< 9 g/dL.
* Pregnancy or breastfeeding.
* History of hypersensitivity to hydrochlorothiazide or furosemide.
* Patients admitted from the Intensive Care Unit.
* Patients with recent cardiac surgery (within the last year) or heart transplant recipients.
* Need for inotropic support to maintain adequate cardiac and/or renal output.

Where it's running

• Hospital Clínico Universitario Lozano Blesa
  Zaragoza, Spain Recruiting
• Hospital Clínico Universitario Lozano Blesa
  Zaragoza, Spain Not yet recruiting

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.