Effect of Non-Invasive Lung Fluid Monitoring for Heart Failure Management in Primary Care: LiLAC-HF
What is LiLAC-HF?
Heart failure is a growing health concern, particularly among the elderly. Heart failure patients often experience repeated hospitalizations. It is currently the most common cause of hospital admissions for people over the age of 65.
Early detection of worsening heart failure is crucial to prevent hospitalisation for heart failure. Despite the increasing focus on providing care closer to home, in line with the principles of person-centred and Integrated Care ("Nära vård"), managing heart failure, particularly identifying worsening heart failure early in primary care remains a challenge.
Remote Dielectric Sensing (ReDS) is a new, non-invasive technology that measures lung fluid concentration in just 45 seconds, presenting the result as a percentage. This fast and accurate method enables early detection of worsening heart failure and can help prevent the need for hospital admission. However, the effects of utilizing the ReDS technology to manage heart failure in primary care settings remain unknown. (Please see. Our Experiences with ReDS Technology)
Therefore, we have developed the LiLAC program, an innovative nurse-led initiative for managing heart failure using a new ReDS technology in primary care. The aim is to reduce hospital admissions through early detection and timely intervention.
The program consists of three components:
1. Lung fluid measurement using ReDS
2. An algorithm for interpreting the ReDS value
3. Action based on the algorithm, including guidance on diuretic dose adjustments, follow-up scheduling, and self-care support for patients to strengthen their ability to monitor heart failure symptoms at home.
The purpose of the LiLAC-HF study is:
1. To examine whether the LiLAC program decreases the number of urgent healthcare visits for heart failure, unplanned heart failure hospitalisations, and all-cause death in patients with heart failure.
2. To evaluate the intervention processes and explore barriers to and facilitators for the implementation of the program.
The LiLAC-HF study is a multicentre, 1:1 randomised controlled trial with a 6-month follow-up. Study participants will be patients diagnosed with heart failure. They will be allocated to either the LiLAC program (intervention group) or the control group. Patients in the intervention group will receive a three-month LiLAC program in addition to usual care. Patients in the control group will receive usual care.
The primary outcome will be the total number of composite endpoints, including acute healthcare visits for heart failure, unplanned heart failure hospitalisations, and all-cause death after three months. Secondary outcomes will include quality of life and self-care. Throughout the randomised controlled trial, a process evaluation will be conducted to assess the fidelity, dose, and reach of the intervention program. Additionally, we will explore both barriers and facilitators for program implementation among study patients and healthcare professionals.
This study provides valuable insights into managing heart failure patients using new technology in primary care settings.
This innovative project is supported by several organizations, including the Swedish Research Council, the Swedish Heart and Lung foundation, The Swedish heart and Lung association, The Kamprad Family Foundation, FORSS (Medical Research Council of Southeast Sweden), Circulation and metabolism CircM, LiU/RÖ strategic research area eHealth and the Research School for Integrated Care (Forskarskolan Nära Vård)
Are You Interested in Our Study?
We are currently (2025) recruiting Swedish primary care centres to participate in our LiLAC-HF study. If you are interested in joining this study, please contact us via email at: lilac-hf@liu.se.
• Vårdcentralen Centrum Flen
Instagram: https://www.instagram.com/lilac_hf_study/
E-mail: lilac-hf@liu.se
Collaborating centres
• Vårdcentralen Centrum FlenClinical trial registration
ClinicalTrials.gov ID: NCT06734065Social media & contact
LinkedIn: https://www.linkedin.com/in/lilac-heart-failure-01252335a/Instagram: https://www.instagram.com/lilac_hf_study/
E-mail: lilac-hf@liu.se
Our Experiences with the ReDS
• Easy to Use: Primary care professionals underwent a half-day training and found the ReDS system straightforward and user-friendly.
• Effective assessment of lung fluid levels: The system is a valuable tool for assessing lung congestion, helping to verify physical examination findings and symptoms.
• Patient Comfort: Patients reported no pain or discomforts during the measurements.
• Quick: The measurement takes just 45 seconds, with the entire process, including explanation, taking around 5 minutes.
Kato NP, Mattisson M, Grahn P, Liljeroos M, Johansson P, Strömberg A, Jaarsma T. Describing the use of remote dielectric sensing and handheld ultrasound in assessing lung congestion in heart failure patients within a primary care setting. Eur J Cardiovasc Nurs. 2025 Mar 3;24(2):325-331. doi: 10.1093/eurjcn/zvae157. PMID: 39749455.
Research group
Financial support
- The Swedish Research Council
- The Swedish Heart and Lung foundation
- The Swedish Heart and Lung Association
- The Kamprad Family Foundation
- FORSS (Medical Research Council of Southeast Sweden)
- The Research School of Integrated care
- LiU/RÖ strategic research area eHealth
- Circulation and metabolism, CircM Linköping university
Publications related to the project
Peer-reviewed articles
1. Kato NP, Mattisson M, Grahn P, Liljeroos M, Johansson P, Strömberg A, Jaarsma T. Describing the use of remote dielectric sensing and handheld ultrasound in assessing lung congestion in heart failure patients within a primary care setting. Eur J Cardiovasc Nurs. 2025 Mar 3;24(2):325-331. doi: 10.1093/eurjcn/zvae157.
2. Kato NP, Svantesson J, Johansson P, Strömberg A, Jaarsma T. Successful use of point-of-care ultrasound for an elderly patient with heart failure in a primary care setting: a case report. Eur Heart J Case Rep. 2024 Sep 13;8(10):ytae511. doi: 10.1093/ehjcr/ytae511.
International Conferences
1. Lundahl, R, Mattisson M, Fried Lang, H; Pak, N-Y, Liljeroos, M, Johansson, P, Strömberg, A, Jaarsma, T, Kato, NP. A feasibility study on non-invasive lung fluid monitoring using ReDS-technology for heart failure management in primary care. ACNAP Congress 2025; 12-14, June; Sophia Antipolis, France2025.
2. Kato NP, Liljeroos M, Mattisson M, Lundahl R, Schoenmaekers A, Johansson P, Strömberg A, Jaarsma T. Effect of non-invasive lung fluid monitoring for heart failure management in primary care settings (LiLAC-HF): study protocol for a randomised controlled trial. Heart Failure Congress 2025; 17-20, May; Belgrade, Serbia2025.
3. Mattisson M, Grahn P, Liljeroos M, Johansson P, Strömberg A, Jaarsma T, Kato N. Experiences of primary care nurses with using a handheld ultrasound device (Vscan) and a remote dielectric sensing (ReDS) device in the assessment of patients with heart failure. ACNAP Congress 2024; 14-15, June; Wrocław, Poland2024.
4. Kato N, Svantesson J, Johansson P, Strömberg A, Jaarsma T. Successful use of point-of-care ultrasound for an elderly patient with heart failure in a primary care setting ACNAP Congress 2024; 14-15, June; Wrocław, Poland2024.
5. Kato N, Mattisson M, Grann P, Liljeroos M, Johansson P, Strömberg A, Jaarsma T. Using non-invasive monitoring devices to detect pulmonary congestion by nurses in primary care: experiences with ReDS and a handheld ultrasound V-scan. ESC Heart Failure 2024; 11-14 May; Lisbon, Portugal2024.
6. Kato N, Klompstra L, Johannsson P, Strömberg A, Jaarsma T. Patient experiences and feasibility with four different types of new equipment to monitor fluid status at home. ESC Heart Failure 2023; Prague, Czech Republic2023.
National conferences
1. Lundahl, R, Mattisson M, Fried Lang, H; Pak, N-Y, Liljeroos, M, Johansson, P, Strömberg, A, Jaarsma, T, Kato, NP. A feasibility study on non-invasive lung fluid monitoring using ReDS-technology for heart failure management in primary care. The Swedish Cardiovascular Spring Meeting 2025; 9-11 April; Malmö, Sweden2025
2. Kato NP, Liljeroos M, Mattisson M, Lundahl R, Schoenmaekers A, Johansson P, Strömberg A, Jaarsma T. Effect of non-invasive lung fluid monitoring for heart failure management in primary care settings (LiLAC-HF): study protocol. The Swedish Cardiovascular Spring Meeting 2025; 9-11 April; Malmö, Sweden2025 (accepted).
3. Kato N, Mattisson M, Grann P, Liljeroos M, Johansson P, Strömberg A, Jaarsma T. Using non-invasive monitoring devices to detect pulmonary congestion by nurses in primary care: experiences with ReDS and a handheld ultrasound V-scan. The Swedish Cardiovascular Spring Meeting 2024; 17-19 April; Göteborg, Sweden2024.
4. Kato NP, Klompstra L, Johannsson P, Strömberg A, Jaarsma T. User-experiences and feasibility with four different types of new equipment for fluid balance monitoring at home from patient´s perspective. The Swedish Cardiovascular Spring Meeting 2023; Stockholm, Sweden2023