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Completed

NCT Number: NCT05174312

Fluid Management of Acute Decompensated Heart Failure Subjects Treated With Reprieve Decongestion Management System (DMS)

The objective of this study is to prospectively compare decongestive therapy administered by the Reprieve DMS system to Optimal Diuretic Therapy (ODT) in the treatment of patients diagnosed with acute decompensated heart failure (ADHF). The main objective is to determine if the Reprieve DMS can more efficiently decongest ADHF patients in comparison to Control Therapy.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Eastern Shore Research Institute, Fairhope, Alabama, United States

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Hospitalized with a diagnosis of heart failure as defined by the presence of at least 1 symptom AND 1 sign.
  • ≥10 pounds (4.5 kg) above dry weight either by historical weights or as estimated by health care provider.
  • Prior use of loop diuretics within 30 says prior to admission.
  • ≥ 18 years of age able to provide informed consent and comply with study procedures.

Exclusion criteria

  • Inability to place Foley catheter or IV catheter.
  • Hemodynamic instability.
  • Dyspnea due primarily to non-cardiac causes.
  • Acute infection with evidence of systemic involvement.
  • Estimated glomerular filtration rate (eGFR) < 20 ml/min/1.73m2 calculated using the MDRD equation or current use of renal replacement therapy.
  • Significant left ventricular outflow obstruction, uncorrected complex congenital heart disease, severe stenotic valvular disease, infiltrative or constrictive cardiomyopathy, acute myocarditis, type 1 acute myocardial infarction requiring treatment, or any other pathology that, in the opinion of the investigator, would make aggressive diuresis poorly tolerated.
  • Inability to follow instructions or comply with follow-up procedures.
  • Other concomitant disease or condition that investigator deems unsuitable for the study, including drug or alcohol abuse or psychiatric, behavioral or cognitive disorders, sufficient to interfere with the patient's ability to understand and comply with the study instructions or follow-up procedures.
  • Severe electrolyte abnormalities.
  • Presence of active coronavirus disease 2019 (COVID-19) infection.
  • Enrollment in another interventional trial during the index hospitalization.
  • Inability to return for follow-up study visits.
  • Life expectancy less than 3 months.
  • Women who are pregnant or intend to become pregnant.

Treatment and study plan

Reprieve Decongestion Management System

Device

The Reprieve Decongestion Management System, or Reprieve DMS, is a hospital bedside fluid management console designed to provide personalized and automated infusion of the IV diuretic furosemide and physiological saline in response to the patient's real-time urine output to safely and rapidly decongest patients suffering from Acute Decompensated Heart Failure.

Diuretic

Drug

Best practices of optimal diuretic dosing such as those demonstrated in recent randomized trials (DOSE, ADVOR, CLOROTIC).

Primary outcomes

  1. Total Urine Sodium Output

    Time frame: 24 hours post-treatment initiation

    Primary efficacy endpoint is total urine sodium output at 24 hours post-treatment initiation.

  2. Clinically Significant Acute Kidney Injury, Severe Electrolyte Abnormality, Symptomatic Hypotension or Hypertensive Emergency.

    Time frame: End of treatment, 0-72 hours.

    Primary safety endpoint includes clinically significant acute kidney injury defined as KDIGO stage 2 or greater AKI [≥ doubling of baseline serum creatinine or use of renal replacement therapy (RRT)], severe electrolyte abnormality (serum potassium <3.0 mEq/L, magnesium <1.3 mEq/L or sodium <125 mEq), symptomatic hypotension or hypertensive emergency.

Secondary outcomes

  1. Net Fluid Loss

    Time frame: End of treatment, 0-72 hours

    Difference in the amount of net fluid removed during primary treatment

  2. Time on IV Loop Diuretics

    Time frame: 0 hours (treatment initiation) through hospital discharge, up to 1-2 weeks

    Time from initiation of IV loop diuretics to discontinuation of IV loop diuretics

Sponsors and collaborators

Lead sponsor

Reprieve Cardiovascular, Inc

Industry

Registry information

Official study title

Fluid Management of Acute Decompensated Heart Failure Subjects Treated With Reprieve Decongestion Management System (DMS) - FASTR Trial

Acronym: FASTR

Important dates

Study start
2022
Primary completion
2025
Study completion
2025
First posted
Dec 30, 2021
Registry last updated
Jun 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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