Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial.
Frances M Russell, Robert R Ehrman, Robinson Ferre and 10 others
PMID 30448355WHAT IT FOUND
Lung ultrasound guided emergency care for acute heart failure will be tested against usual care to see if congestion clears faster within 6 hours.
No patient results are reported.
Key findings
01The trial plans to enrol 130 patients with acute heart failure from 5 emergency departments in the United States and compare lung ultrasound guided care with structured usual care.
02The primary planned outcome is the number of patients with 15 or fewer B-lines on lung ultrasound 6 hours after enrolment.
03The protocol treats hypotension and acute kidney injury in the first 12 hours as safety endpoints, and it will call patients at 30 and 90 days after discharge.
STILL TO COME
How it was doneWhat it means for RNs
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What it does not show
No results are reported, so the paper cannot show whether ultrasound guided care helps patients. It is a pilot design, not a definitive trial. Both arms follow the same treatment protocol, so the study cannot separate the effect of usual care from protocol care. B-line counts depend on the person scanning and reading the ultrasound images. The study team cannot be blinded to the patient's clinical condition. The primary outcome is a B-line count, not death, urgent healthcare visits or rehospitalisation.
Declared interests
The trial is funded by NHLBI. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read this as evidence that lung ultrasound guided care decongests acute heart failure patients faster. It is a protocol with no patient outcomes, and treatment decisions in the ultrasound arm are made within a shared treatment protocol.