Evidence map›Paper›PMID 34246609›Full record

Trial reportJACC. Heart failure2021

Lung Ultrasound-Guided Emergency Department Management of Acute Heart Failure (BLUSHED-AHF): A Randomized Controlled Pilot Trial.

Peter S Pang, Frances M Russell, Robert Ehrman, Rob Ferre, Luna Gargani, Phillip D Levy, Vicki Noble, Kathleen A Lane, Xiaochun Li, Sean P Collins

Erratum issued Registry-linked trialOpen access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JACC. Heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03136198 (B-lines Lung Ultrasound Guided ED Management of Acute Heart Failure Pilot Trial), which is not on this map. Cited by 43 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 2 pooled it
6.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03136198 phase2completednot on this map

B-lines Lung Ultrasound Guided ED Management of Acute Heart Failure Pilot Trial

TypeinterventionalSponsorIndiana UniversityRan2017 to 2019Enrolled130ConditionsHeart Failure, Heart Failure Acute, Acute Cardiac Pulmonary Edema, Acute Cardiac FailureArmsLUS-guided strategy-of-care, Usual Care, Intravenous Loop Diuretic, Vasodilator, Non invasive Ventilation (NIV)
3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.

  1. Pooled it
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  8. Advances in thoracic ultrasound.The European respiratory journal · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 2 countries.

Peter S PangDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. Electronic address: ppang@iu.edu.
Frances M RussellDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Robert EhrmanDepartment of Emergency Medicine, Wayne State School of Medicine, Detroit, Michigan, USA.
Rob FerreDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Luna GarganiInstitute of Clinical Physiology, National Research Council, Pisa, Italy.
Phillip D LevyDepartment of Emergency Medicine, Wayne State School of Medicine, Detroit, Michigan, USA.
Vicki NobleDepartment of Emergency Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Kathleen A LaneDepartment of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Xiaochun LiDepartment of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Sean P CollinsDepartment of Emergency Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Indiana University School of MedicineWayne State University · USCase Western Reserve University · USIndiana University – Purdue University Indianapolis · USIstituto di Fisiologia Clinica · ITVanderbilt University · US

Funding

B-lines Lung Ultrasound Guided ED Management of Acute Heart Failure (BLUSHED-AHF)R34HL136986 · NHLBI · INDIANA UNIVERSITY INDIANAPOLIS · PI PANG, PETER S · 2017 to 2018
$758k
NHLBI NIH HHS R34 HL136986
6 · The paper itself

Abstract

objectivesThe goal of this study was to determine whether a 6-hour lung ultrasound (LUS)-guided strategy-of-care improves pulmonary congestion over usual management in the emergency department (ED) setting. A secondary goal was to explore whether early targeted intervention leads to improved outcomes.

backgroundTargeting pulmonary congestion in acute heart failure remains a key goal of care. LUS B-lines are a semi-quantitative assessment of pulmonary congestion. Whether B-lines decrease in patients with acute heart failure by targeting therapy is not well known.

methodsA multicenter, single-blind, ED-based, pilot trial randomized 130 patients to receive a 6-hour LUS-guided treatment strategy versus structured usual care. Patients were followed up throughout hospitalization and 90 days' postdischarge. B-lines ≤15 at 6 h was the primary outcome, and days alive and out of hospital (DAOOH) at 30 days was the main exploratory outcome.

resultsNo significant difference in the proportion of patients with B-lines ≤15 at 6 hours (25.0% LUS vs 27.5% usual care; P = 0.83) or the number of B-lines at 6 hours (35.4 ± 26.8 LUS vs 34.3 ± 26.2 usual care; P = 0.82) was observed between groups. There were also no differences in DAOOH (21.3 ± 6.6 LUS vs 21.3 ± 7.1 usual care; P = 0.99). However, a significantly greater reduction in the number of B-lines was observed in LUS-guided patients compared with those receiving usual structured care during the first 48 hours (P = 0.04).

conclusionsIn this pilot trial, ED use of LUS to target pulmonary congestion conferred no benefit compared with usual care in reducing the number of B-lines at 6 hours or in 30 days DAOOH. However, LUS-guided patients had faster resolution of congestion during the initial 48 hours. (B-lines Lung Ultrasound-Guided ED Management of Acute Heart Failure Pilot Trial; NCT03136198).

Indexed as

AftercareHeart FailureEmergency Service, HospitalHumansLungPatient DischargePilot ProjectsSingle-Blind MethodUltrasonographyUltrasonography, Interventionalacute heart failureB-linescongestionlung ultrasound

Identifiers

PMID34246609
PMCPMC8419011
OpenAlexW3178104743

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.