Using lung ultrasound to guide treatment for acute heart failure
Investigating aCute heArt failuRe Decongestion Guided by Lung UltraSonography (IcarUS) : a Randomized Controlled Trial
NA · University Hospital, Geneva · NCT06465498
This study is testing if using lung ultrasound to guide treatment can help adults with acute heart failure leave the hospital sooner and feel better compared to standard care.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 222 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University Hospital, Geneva (other) |
| Locations | 5 sites (Geneva, Canton of Geneva and 4 other locations) |
| Trial ID | NCT06465498 on ClinicalTrials.gov |
What this trial studies
This clinical trial investigates the effectiveness of a lung ultrasonography (LUS)-guided decongestion strategy for adults hospitalized with acute heart failure (AHF). It aims to determine if this approach can shorten hospital stays, reduce early readmissions, and improve patients' symptoms and quality of life compared to traditional physical examination methods. The study will be conducted as a multicenter, blinded, randomized controlled trial involving 222 participants, who will be assigned to either the LUS-guided strategy or standard care within 48 hours of hospital admission. The primary outcome will measure the number of days spent alive outside the hospital within 40 days of inclusion.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18 and older who are hospitalized for congestive acute heart failure and have elevated levels of N-terminal pro-brain natriuretic peptide.
Not a fit: Patients with isolated right heart failure, severe hypotension, or conditions mimicking lung edema may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could lead to improved patient outcomes and reduced healthcare costs for those suffering from acute heart failure.
How similar studies have performed: While lung ultrasonography has shown benefits in chronic heart failure management, this specific application in acute heart failure is novel and has not been extensively tested.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * ≥ 18 years old * Planned or actual admission to intermediate care units, general internal medical or cardiology wards * Diagnosis of congestive AHF on admission chart (primary or secondary diagnosis) * Raised value of N terminal-pro-brain natriuretic peptide (≥1000 ng/l). Key Exclusion Criteria: * Known isolated right heart failure * Systolic blood pressure \<90 mmHg, mean arterial pressure \<65 mmHg at the moment of inclusion * The following conditions mimicking lung cardiogenic oedema on LUS if known at inclusion and documented: Interstitial lung disease, lung cancer or metastasis, acute respiratory distress syndrome, pulmonary contusion * Known virologically confirmed SARS-CoV-2 pneumonia in the preceding 3 months * Unwillingness to give consent * Subjects who are pregnant or breastfeeding * Hospitalisation for palliative care and probable end-life within 30 days
Where this trial is running
Geneva, Canton of Geneva and 4 other locations
- Trois-Chêne Hospital, Geneva Univesity Hospitals — Geneva, Canton of Geneva, Switzerland (RECRUITING)
- Geneva University Hospitals — Geneva, Canton of Geneva, Switzerland (RECRUITING)
- Inselspital, Universitätspital — Bern, Switzerland, Switzerland (RECRUITING)
- Fribourg University Hospital — Fribourg, Switzerland (RECRUITING)
- Ospedale Civico, Ente Ospedaliero Cantonale — Lugano, Switzerland (TERMINATED)
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Acute Heart Failure, Lung ultrasonography, Ultrasound, Point-of-care ultrasonography, Decongestion, Diuretic