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Updated: Jul 3, 2025

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
Semi-quantitative pulmonary congestion score: prevalence and diuretic management implications after heart failure
F J Pastor-Pérez1, M Veas-Porlán1, N Fernández-Villa1
1Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
Introduction:
Persistent congestion after heart failure (HF) discharge is associated with a higher risk of readmissions.
Material And Methods:
eighty-two patients included after HF discharge. The aim of the study was to characterize semiquantitatively the degree of pulmonary congestion and its changes, describing the relationship between these findings and diuretic management.
Results:
On the first visit, despite the absence of clinical congestion in the majority of patients, half of the had some degree of pulmonary congestion by ultrasound. After global assessment in this initial visit (clinical and ultrasound) the diuretic was lowered in 50 patients (60%), kept the same in 16 (20%) and it was increased in the rest. In the 45 patients without ultrasound congestion, diuretic reduction was attempted in 80%, being this strategy successful in the majority of them.
Conclusions:
Lung ultrasound, using simple quantification methods, allows its real incorporation into clinical practice, helping us in the decision making process.
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