The aim of this study is to evaluate the effectiveness of loop diuretic adaptative algorithm that is based on machine learning, urine output prediction tool, in decongestion of acute heart failure patients. A total of 90 patients will be enrolled in the study. Of these, 45 will be assigned to the algorithm-based intervention group, while the remaining 45 will serve as the control group. In the control group, all decisions regarding diuretic therapy will be made solely by the attending physician, without the use of the algorithm. Patients will receive intravenous furosemide, with the initial dose determined by the attending physician. Two hours after administration of the diuretic, a spot urine sample will be collected to measure sodium and creatinine concentrations. Based on these values, the 6-hour urine output will be estimated using the machine learning, urine output prediction tool (http://diuresis.umw.edu.pl). This estimate will guide the diuretic therapy plan for the first 24 hours of hospitalization. On the second day, the procedure will be repeated using the same methodology.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
90
Diuretic treatment per attending physician.
Patient will receive standarized furosemide dosing based on the result of the algorithm-estimated 6h urine output (profiles of diuretic response).
Wroclaw Medical University
Wroclaw, Dolnosląskie, Poland
RECRUITINGWroclaw Medical University
Wroclaw, Lower Silesian Voivodeship, Poland
RECRUITINGCumulative diuresis over 48 hours.
Total urine output during the 48-hour duration of the study.
Time frame: 48 hours
Cumulative diuresis during first 24h of the study.
The total urine output during the first 24 hours of the study.
Time frame: 24 hours
Cumulative diuresis on the second 24h of the study.
The total urine output during the second 24 hours of the study.
Time frame: 48 hours
Cummulative natriuresis over 48 hours of the study.
The total amount of sodium excreted in the urine during the 48-hour duration of the study.
Time frame: 48 hours
Diuresis calculated per dose of loop diuretic over 48 hours of the study.
The volume of urine output relative to the total dose of loop diuretic administered during the study period.
Time frame: 48 hours
Weight change at 24 hours.
The difference in body weight measured at 24 hours compared to baseline.
Time frame: 24 hours
Weight change at 48 hours.
The difference in body weight measured at 48 hours compared to baseline.
Time frame: 48 hours
Total length of hospitalization.
This refers to the total length of the hospital stay, measured in days, from admission to discharge.
Time frame: Up to 60 days
Percentage of patients accurately red-flagged.
Patients with an estimated 6-hour urine output of less than 900 ml will be red-flagged. This outcome indicates the proportion of patients who were correctly identified (red-flagged) as poor diuretic responders.
Time frame: 48 hours
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