Randomized Controlled Trial of urinE chemiStry Guided aCute heArt faiLure treATmEnt (ESCALATE)

Korábbi kezelés

• Concurrent use of ototoxic medications including intravenous aminoglycosides and cisplatin

Más betegség

• End Stage Renal Disease (ESRD) requiring dialysis
• Acute Coronary Syndrome - presentation consistent with myocardial ischemia AND new ST-Segment elevation/depression
• End Stage Heart Failure: transplant list or ventricular assist device
• LV outflow obstruction, severe uncorrected stenotic valvular disease or severe restrictive cardiomyopathy

Laborértékek

• Severe, uncorrected serum electrolyte abnormalities at the time of consent (serum potassium <3.0 mEq/L, magnesium <1.0 mEq/L or sodium <125 or >150 mEq/l)

Egyéb

• Need for immediate intubation
• Temperature > 100.5ºF
• Systolic Blood Pressure < 90 mmHg at time of consent
• Greater than 2 doses of IV diuretic administered at the time of screening from the time of the hospital presentation leading to this admission (outside hospital time is included)
• Lack of informed consent

• Age > 18
• Emergency Department diagnosis of Acute Heart Failure (AHF)
• Any one of the following:
  • Chest radiograph or lung ultrasound consistent with AHF ii. Jugular venous distension iii. Pulmonary rales on auscultation iv. Lower extremity edema v. S3 gallop
• > 10 pounds of volume overload physician estimate or historical dry weight
• IV diuretic ordered or planned to be during first 24 hours of ED or inpatient stay