Search continues for heart failure care in the emergency department

Lung ultrasound concept

Lung ultrasound did not help emergency departments (EDs) manage acute heart failure patients in their initial hours of presenting with symptoms, according to the findings of a randomized pilot trial.

The trial, called BLUSHED-AHF, short for B-lines lung ultrasound guided ED management of acute heart failure, was a single-blind trial conducted at four EDs in the U.S. in 2017-2019. Lung ultrasound B-lines are markers of pulmonary congestion. The study involved 130 people who were randomized to either a lung ultrasound-guided treatment strategy or usual care for acute heart failure. And all participants had to have at least 15 B-lines at the time of trial enrollment.

Heart failure treatment targeting lung ultrasound guided B-lines left patients no less congested at six hours compared to usual care in the emergency department. And both groups shared similar B-line counts at 6 hours, average number of days alive and out of the hospital.

Researchers suggest that the search continues for a practical, noninvasive, objective, and reproducible approach that can guide in-hospital decongestive therapy for heart failure. The study, which published online in JACC: Heart Failure, was funded by NHLBI.