The role of intra-abdominal pressure and point of care ultrasound to guide decongestive therapy in Heart Failure (ABDOPOCUS-HF)

Prior treatment

• Patients receiving renal replacement therapy (ultrafiltration or peritoneal dialysis).
• Renal transplant recipients
• Previous history of hypersensitivity to hydrochlorothiazide or furosemide.

Other illness

• Heart rate at admission > 170 beats per minute (bpm)
• Acute myocardial ischemia
• Patients with recent cardiac surgery (last year) or cardiac transplant recipients
• Need for inotropic support to maintain adequate cardiac and/or renal output

Lab values

• Serum hemoglobin < 9 g/dL

Other

• Patient with stay in the internal medicine department > 24 hours
• Systolic blood pressure at admission < 100 mmHg
• Cardiogenic shock
• Patients whose origin is the Intensive Care Unit
• Pregnancy or lactation
• Absence of sufficient clinical congestion (ADVOR score = 0 at the time of randomization)
• Patient refusal to participate in the clinical trial
• Inability or contraindication to bladder catheterization

• Men or women over 18 years of age
• Diagnosis of HF based on the latest HF guidelines published in 2022
• NT-proBNP > 1000 pg/mL or BNP > 250 pg/mL
• Bladder catheterization in order to perform intra-abdominal pressure measurement
• Intravascular or mixed pattern of congestion, defined as the presence of one or more clinical signs of congestion (edema, ascites and/or pleural effusion)
• Signature of the informed consent