Key result
As a study protocol, the EUC-CHF trial plans to evaluate whether early continuous ultrafiltration is superior to intravenous loop diuretics in 40 Chinese patients with acute decompensated heart failure.
Why the study?
Loop diuretics for fluid overload in advanced heart failure can have limited efficacy and adverse effects, and evidence is uncertain whether early ultrafiltration is more effective for relieving edema.
Does early continuous ultrafiltration improve weight loss and dyspnea severity score and reduce major bleeding compared to intravenous loop diuretics in Chinese patients with acute decompensated heart failure?
RCT (n=40)
Open-label
1:1 sequential
No
Does early continuous ultrafiltration improve weight loss and dyspnea severity score and reduce major bleeding compared to intravenous loop diuretics in Chinese patients with acute decompensated heart failure?
The EUC-CHF trial protocol describes a prospective study to evaluate whether early continuous ultrafiltration is superior to intravenous loop diuretics for decongestion in Chinese patients with acute decompensated heart failure.
Early UF for edema in advanced HF remains unproven observationally; leaves open need for RCTs versus loop diuretics.
BACKGROUND: Conventional pharmacologic therapies aim to reduce fluid overload in advanced heart failure (HF) represented by intravenous (IV) loop diuretics (LDs) have sometimes not so efficacious and been reported to have side effects such as unpredictable removal of water and sodium and electrolyte disturbance. It is not certain whether early ultrafiltration (UF) is effective than LDs in relieving edema. Given the weakness of evidence for early UF in patients with fluid overload, recommendations of UF in guidelines is considered as second-line therapy only for patients with refractory congestion, who failed to respond to LD-based strategies. METHODS: The early continuous ultrafiltration in Chinese patients with congestive heart failure (EUC-CHF) trial is an open-label, registry-based, prospective study, recruiting patients with severe acute decompensated HF who are hospitalized for HF worsening due to overt fluid overload 24 h from hospital admission. Forty patients will be enrolled to two treatment groups (n = 20 for each group). The primary outcomes are the changes of weight loss and dyspnea severity score after treatment, as well as the occurrence of clinically overt major bleeding. DISCUSSION: EUC-CHF trial was primarily designed to evaluate the efficacy and safety of early UF in patients with acute decompensated HF to reduce volume overload and improve clinical outcome. The trial aims to determine if early UF in acute HF is superior to IV LDs in clinical parameter improvement without adverse events and prevents rehospitalization up to 30 days. Also the trial is expected to establish a scoring system based on Chinese population to guide early UF treatment in appropriate patients. EUC-CHF is one of the first controlled trials tailored to determine the benefit of UF with 24 h from hospital admission. TRIAL REGISTRATION: www.chictr.org.cn, ChiCTR1800019556. Registered on 18 November 2018.
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Yang et al. (2019) conducted an RCT in Acute decompensated heart failure (n=40). Early continuous ultrafiltration vs. Standard medical therapy (intravenous loop diuretics) was evaluated on Changes of weight loss and dyspnea severity score after treatment, and occurrence of clinically overt major bleeding. As a study protocol, the EUC-CHF trial plans to evaluate whether early continuous ultrafiltration is superior to intravenous loop diuretics in 40 Chinese patients with acute decompensated heart failure.
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