Lung ultrasound-guided therapy to reduce urgent visits and readmissions in heart failure patients: protocol for a systematic review and meta-analysis of randomized clinical trials
Terapia guiada por ultrassonografia pulmonar para reduzir visitas de urgência e readmissões em pacientes com insuficiência cardíaca: protocolo de revisão sistemática e meta-análise de ensaios clínicos randomizados
William Suzart Coutinho de Araujo, Marina Danielle Senna Souza, Ana Carolina Silva Malta, Dhule Kelly Souza Miranda, Leilla Stefany de Jesus Ferreira, Bruno Souza Soares, Marcelo Farani López, Giulliano Gardenghi, Priscilla Flávia de Melo Fernandes
Abstract
Background: Congestive heart failure is a common condition among hospitalized patients, often linked to high rates of readmission and mortality. Although biomarkers like N-terminal pro-B-type natriuretic peptides (NT-proBNP) are commonly used for monitoring congestive heart failure, their isolated use is not recommended by current guidelines. Lung ultrasound has emerged as a promising non-invasive tool to assess pulmonary congestion and monitor treatment response. Aim: To assess the effectiveness of lung ultrasound-guided therapy in reducing urgent visits, readmissions, and mortality in heart failure patients compared to standard care. Methods: A systematic review and meta-analysis of published randomized clinical trials will be conducted, including adult hospitalized heart failure patients. Studies will be sourced from databases such as PubMed, EMBASE, and Cochrane without language and date restrictions. Two independent reviewers will screen and select studies based on PICO criteria. Primary outcomes include rates of urgent visits, readmissions, and mortality within 180 days. Methodological quality will be assessed using the Risk-of-Bias 2 tool, and the certainty of evidence will be evaluated using the GRADE system. Registration: In accordance with the guidelines, our systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 11 October 2024 (registration number: CRD420250596077).
Keywords
Resumo
Introdução: A insuficiência cardíaca congestiva é uma condição comum entre pacientes hospitalizados, frequentemente associada a altas taxas de readmissão e mortalidade. Embora biomarcadores como o peptídeo natriurético tipo B N-terminal (NT-proBNP) sejam amplamente utilizados para monitoramento da insuficiência cardíaca congestiva, seu uso isolado não é recomendado pelas diretrizes atuais. A ultrassonografia pulmonar tem se destacado como uma ferramenta não invasiva promissora para avaliar a congestão pulmonar e monitorar a resposta ao tratamento. Objetivo: Avaliar a eficácia da terapia guiada por ultrassonografia pulmonar na redução de visitas de urgência, readmissões e mortalidade em pacientes com insuficiência cardíaca, em comparação ao tratamento convencional. Métodos: Será conduzida uma revisão sistemática e meta-análise de ensaios clínicos randomizados publicados, incluindo pacientes adultos hospitalizados por insuficiência cardíaca. Os estudos serão obtidos em bases de dados como PubMed, EMBASE e Cochrane, sem restrições de data e idioma. Dois revisores independentes realizarão a triagem e seleção dos estudos com base nos critérios PICO. Os desfechos primários incluirão as taxas de visitas de urgência, readmissões e mortalidade em até 180 dias. A qualidade metodológica será avaliada utilizando a ferramenta Risk-of-Bias 2 e a certeza da evidência será avaliada pelo sistema GRADE. Registro: De acordo com as diretrizes, o protocolo desta revisão sistemática foi registrado no Registro Internacional Prospectivo de Revisões Sistemáticas (PROSPERO) em 11 de outubro de 2024 (número de registro: CRD420250596077).
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Referências
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Submetido em:
14/01/2025
Aceito em:
23/12/2025
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