LUDT-ADHF trial: Lung ultrasound-guided diuretic therapy for hospitalized patients with acute decompensated heart failure: An open-label clinical trial

• Published in: Heart & lung 2025-01, Vol.69, p.155-162
• Main Authors: Kashoob, Masoud, Al-Busaidi, Salim, Al-Maqbali, Juhaina Salim, Al-Badi, Amira, Aalhamad, Aya, Falahi, Zubaida Al, Huraizi, Aisha Al, Farhan, Hatem Al, Zeedy, Khalfan Al, Hashim, Abdul Hakeem Al, Al-Ghailani, Mohammed H, Shoaib, Muhammad, Bingawi, Haitham El, Al Alawi, Abdullah M.
• Format: Article
• Language: English
• Subjects: 90-day readmissions; Acute decompensated heart failure; Acute Disease; Aged; All-cause readmissions; B-line; Diuretics - administration & dosage; Diuretics - therapeutic use; Female; Heart Failure - complications; Heart Failure - drug therapy; Hospitalization; Hospitalization - statistics & numerical data; Humans; Length of Stay - statistics & numerical data; Lung - diagnostic imaging; Lung ultrasound; Male; Middle Aged; Mortality; Patient Readmission - statistics & numerical data; Treatment Outcome; Ultrasonography - methods
• ISSN: 0147-9563; 1527-3288; 1527-3288
• DOI: 10.1016/j.hrtlng.2024.10.001

•Pulmonary congestion is a critical predictor in heart failure patients, significantly impacting mortality and hospitalization rates.•Assessing decongestion before discharge is crucial for reducing rehospitalization and mortality rates.•Addressing these challenges can maximize Lung Ultrasound (LUS)-guided therapy benefits and improve care for Acute Decompensated Heart Failure (ADHF) patients in clinical settings. Background Acute Decompensated Heart Failure (ADHF) constitutes a major reason for hospital admissions and significantly contributes to increased morbidity and mortality. Limited research indicates that lung ultrasound (LUS) may enhance the care for patients with ADHF. Objectives The purpose of this study was to evaluate the impact of LUS-guided diuretic therapy on reducing length of hospital stay (LOS) and 90-day readmissions among patients with ADHF. Methods This open-label, non-randomized clinical trial included patients with ADHF managed with diuretics based on LUS findings of B-lines and pleural effusion (LUS group) compared to those receiving standard care (control group). The primary outcome was LOS during the index admission, and secondary outcomes included 90-day ADHF readmissions, all-cause readmissions, and safety parameters like acute kidney injury, hypokalemia, and hypotension. Results The study included a total of 77 patients, segregated into two groups: control and LUS. The median age of the patients was 68 years, with women slightly outnumbering men (53.25%, n=41). The most prevalent comorbidities were hypertension (88.31%, n=68), diabetes mellitus (59.74%, n=46), and chronic kidney disease (66.23%, n=51). The LUS group had a shorter LOS, though not statistically significant (4 vs five days, p= 0.175). Patients in the LUS group had significantly fewer 90-day ADHF readmissions compared to the control group (10.53% vs. 35.9%; p