The purpose of the study is to determine if there is a reduction in the length of stay and rates of rehospitalization for patients diagnosed with congestive heart failure when physicians are provided daily measurements of peripheral venous pressure versus no daily measurements of peripheral venous pressure.
The objective of the study is to evaluate the effectiveness of standard clinical care versus standard clinical care directed by peripheral venous pressure on length of hospital stay and incidence of rehospitalization among heart failure patients. The study team hypothesizes that compared to standard clinical care the peripheral venous pressure-guided therapy is associated with shorter hospital stay and lesser incidence of 30-day rehospitalization. The study team will also collect data to determine if peripheral venous pressure-guided care is associated with reduced incidence of 6-month rehospitalization, improvement in symptoms or lab indices, lesser new incidence of dialysis, change in use of diuretics, and lesser use of echocardiograms.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
600
Peripheral venous pressure measures provided to physicians daily up to 8 days, with a research note in the electronic medical record containing standardized recommendations for case also provided daily. Care changes up to clinical provider discretion.
Usual standard clinical care
Aurora St. Luke's Medical Center
Milwaukee, Wisconsin, United States
Length of hospital stay
Number of days from admission to discharge
Time frame: up to day 8
Number of subjects rehospitalized
Number of subjects in each group who have been rehospitalized
Time frame: Day 30 post index hospitalization
Number of subjects rehospitalized
Number of subjects in each group who have been rehospitalized
Time frame: Month 6 post index hospitalization
Number of subjects with exertional dyspnea
Number of subjects in each group experiencing dyspnea according to the New York Heart Association Class
Time frame: Day 1 and date of discharge (up to day 8)
Number of subjects with exertional orthopnea
Number of subjects in each group experiencing orthopnea according to the New York Heart Association Class
Time frame: Day 1 and date of discharge (up to day 8)
Number of subjects with new need for dialysis during index hospitalization
Number of subjects in each group with new need for dialysis during index hospitalization
Time frame: Day 1 and date of discharge (up to day 8)
Number of subjects with diuretic use
Number of subjects in each group with diuretic use during index hospitalization
Time frame: Day 1 and date of discharge (up to day 8)
Number of subjects with echocardiograms
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Number of subjects in each group with echocardiograms performed (with results) during index hospitalization
Time frame: Day 1 and date of discharge (up to day 8)
Number of subjects with all-cause death
Number of subjects in each group with all-cause death
Time frame: Month 6 post index hospitalization
Number of subjects with cardiac-related death
Number of subjects in each group with cardiac-related death
Time frame: Month 6 post index hospitalization