A Randomized Trial of Protocolized Diuretic Therapy Compared to Standard Care in Emergency Department Patients With Acute Heart Failure
This is a randomized trial of protocolized diuretic therapy guided by urinary sodium compared to structured usual care in ED patients with AHF. Participants will be recruited following an initial standard evaluation in the ED and randomized in a 1:1 fashion to structured usual care or protocolized diuretic therapy guided by urinary sodium.
• Age \> 18
• Emergency Department diagnosis of Acute Heart Failure (AHF)
• Any one of the following:
• i. 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