Acute decompensated heart failure combined with diuretic resistance
Conditions
Interventions
Observation group:None
Sponsors
The Affiliated Panyu Central Hospital, Guangzhou Medical University
Eligibility
Sex/Gender
All
Age
18 Years to 85 Years
Inclusion criteria
Inclusion criteria: 1.Age: 18 - 85 years old; 2.Meets the diagnostic criteria for acute decompensated heart failure as stipulated in the "Chinese Guidelines for Diagnosis and Treatment of Heart Failure 2024": presenting with symptoms and signs of acute heart failure, including but not limited to exertional dyspnea, nocturnal paroxysmal dyspnea, sitting-up breathing, fatigue, fluid retention (such as pulmonary edema or peripheral edema), etc., with NYHA cardiac function classification of III-IV grade, for patients under 50 years old, NT-proBNP level > 450 ng/L, for those aged 50-75 years old, > 900 ng/L, for those over 75 years old, > 1800 ng/L, and > 1200 ng/L when there is renal dysfunction; 3.Meets the diagnostic criteria for diuretic resistance as stipulated in the "Chinese Expert Consensus on Diagnosis and Management of Diuretic Resistance in Heart Failure Patients 2024", where after daily intravenous use of furosemide at a dose of = 80 mg or using an equivalent dose of other diuretics, the appropriate urine output (0.5 - 1.0 mL/kg/h) cannot be achieved or the daily weight loss is less than 0.5 - 1.0 kg; 4.Judged by the investigator that recombinant human brain natriuretic peptide treatment is necessary; 5.The patient or the legal representative of the patient consents to participate in the trial and signs the informed consent form;
Exclusion criteria
Exclusion criteria: 1.There is a risk of developing cardiogenic shock, and the dosage of vasoactive drugs required is greater than 0.4ug/kg/min; 2.Patients who the researchers determine are not suitable for using vasodilator drugs, such as those with severe valve stenosis, restrictive or obstructive cardiomyopathy, restrictive pericarditis, pericardial tamponade or other conditions where cardiac output relies on venous return or is suspected of having low cardiac filling pressure; 3.Uncorrectable hypotension, with systolic blood pressure lower than 90mmHg after treatment with vasopressors and mean arterial pressure still lower than 65mmHg. 4.Patients who did not reach diuretic resistance before enrollment but have already used recombinant human brain natriuretic peptide. 5) Patients known or suspected to be allergic to the drugs or ingredients described in this protocol. 5.Patients known or suspected to be allergic to the drugs or ingredients described in this protocol. 6.Patients with an estimated survival time of less than 24 hours. 7.Patients participating in another clinical trial simultaneously. 8.Social and physiological vulnerable groups, such as children, pregnant women, those with mental disorders, those with cognitive impairments, end-stage patients, prisoners, employees and students, etc. 9.Any other situation that the researcher considers may pose risks to the patient.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| NT-proBNP; | — |
Secondary
| Measure | Time frame |
|---|---|
| ENaC-a;Angiotensin II;NCCT;ENaC-?;aldosterone; | — |
Countries
China
Contacts
Public ContactYe Jingkun
The Affiliated Panyu Central Hospital, Guangzhou Medical University
Outcome results
None listed