Bedside Ultrasound-guided Volume Management and Discharge Timing for Patients With Heart Failure During Hospitalization: A Randomized Controlled Trial

Condition(s) studied

Investigational drug(s) / intervention(s)

Ultrasound-Guided Volume Assessment and Decongestion Strategy (UVADS): Unique Combination: Simultaneously tracks IVC collapsibility index (\>50%) + pulmonary B-line counts (≤5) to guide therapy, unlike studies using either metric alone.Thresholds Tested: Compares ESC consensus thresholds (IVC \<2.1cm) vs. exploratory Asian-optimized thresholds (IVC \<1.8cm) in Subgroup B.

clinical assessment: Discharge based on symptoms/signs alone: Clinical congestion score ≤2 + NYHA class ≤II

Study summary

Brief Summary of the POCUS-HF Study

The goal of this clinical trial is to determine whether using bedside ultrasound (POCUS) to guide fluid management and discharge timing can improve outcomes for hospitalized heart failure (HF) patients. The study aims to answer the following questions:

Does POCUS-guided management (using measurements of the inferior vena cava (IVC) and lung B-lines) reduce the risk of rehospitalization and death compared to standard clinical assessment alone? What is the optimal IVC value for determining the safest discharge timing for HF patients in China and Asia?

Researchers will compare two groups:

Intervention group: Patients receive daily POCUS assessments (IVC diameter and lung B-lines) to guide fluid management and discharge decisions.

Control group: Patients receive standard care based on clinical symptoms and signs alone.

Participants will:

Undergo twice-daily POCUS measurements during hospitalization (intervention group only).

Be discharged based on either POCUS criteria (IVC and B-line thresholds) or clinical criteria (control group).

Attend follow-up visits at 7 days, 1 month, 3 months, 6 months, and 1 year after discharge to track rehospitalizations, complications, and survival.

The study hopes to provide evidence that POCUS can help reduce residual fluid overload at discharge, lower rehospitalization rates, and improve long-term outcomes for HF patients.

Eligibility

Primary outcome measure(s)

• Composite rate of heart failure-related rehospitalization or cardiac death within 1 year post-discharge — Assessed at 30 days, 90 days, 6 months, and 1 year post-discharge
  Components: HF rehospitalization: Unplanned admission \>24 hours requiring IV diuretics/vasoactive drugs. Cardiac death: Death from HF, MI, arrhythmia, or unexplained sudden death.

Trial sites (1)

Other trials for the same condition