Enthusiasm for high-dose nitroglycerin in severe ADHF is no longer fringe. The professional society endorsements for high-dose nitroglycerin push high-dose nitroglycerin in ADHF with pulmonary edema from cutting-edge to mainstream and may facilitate the use of this approach for select patients.
Explore This Issue
ACEP Now: Vol 42 – No 02 – February 2023Dr. Westafer (@Lwestafer) is an attending physician and research fellow at Baystate Medical Center, clinical instructor at the University of Massachusetts Medical School in Worcester, and co-host of FOAMcast.
References
- Peacock WF, Hollander JE, Diercks DB, et al. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008;25(4):205–9.
- Miró Ò, Gil V, Martín-Sánchez FJ, et al. Morphine use in the ED and outcomes of patients with acute heart failure: A propensity score-matching analysis based on the EAHFE registry. Chest. 2017;152(4):821–32.
- American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Acute Heart Failure Syndromes. Clinical policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with acute heart failure syndromes: Approved by ACEP board of directors, June 23, 2022. Ann Emerg Med. 2022;80(4):e31–59.
- McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–726.
- UpToDate [Internet]. [cited 2023 Jan 11]; Available from: https://www.uptodate.com/contents/treatment-of-acute-decompensated-heart-failure-specific-therapies.
- Levy P, Compton S, Welch R, et al. Treatment of severe decompensated heart failure with high-dose intravenous nitroglycerin: a feasibility and outcome analysis. Ann Emerg Med. 2007;50(2):144–52.
- Mathew R, Kumar A, Sahu A, Wali S, Aggarwal P. High-dose nitroglycerin bolus for sympathetic crashing acute pulmonary edema: A prospective observational pilot study. J Emerg Med. 2021;61(3):271–7.
- Wilson SS, Kwiatkowski GM, Millis SR, Purakal JD, Mahajan AP, Levy PD. Use of nitroglycerin by bolus prevents intensive care unit admission in patients with acute hypertensive heart failure. Am J Emerg Med. 2017;35(1):126–31.
- Cotter G, Metzkor E, Kaluski E, et al. Randomised trial of high-dose isosorbide dinitrate plus low-dose furosemide versus high-dose furosemide plus low-dose isosorbide dinitrate in severe pulmonary oedema. Lancet. 1998;351(9100):389–93.
- Patrick C. Prehospital safety of intravenous bolus dose nitroglycerin in acute pulmonary edema patients. J Am Coll Cardiol. 2022;79(9):543.
- Perlmutter MC, Cohen MW, Stratton NS, Conterato M. Prehospital treatment of acute pulmonary edema with intravenous bolus and infusion nitroglycerin. Prehosp Disaster Med. 2020;35(6):663–8.
- Wang K, Samai K. Role of high-dose intravenous nitrates in hypertensive acute heart failure. Am J Emerg Med. 2020;38(1):132–7.
Pages: 1 2 3 | Single Page
No Responses to “High Dose Nitroglycerin in Acute Heart Failure Goes Mainstream”