Nitroglycerin (NTG) is an important preload reducer in acute pulmonary edema, and even modestly reduces afterload with high doses. Doses ~ 200 mcg/min. Am J Emerg Med. When combined with phenylephrine may offer decrease in preload as well as decrease in heart rate (and possibly increased perfusion pressure and afterload). The primary outcomes were the frequency of intensive care unit (ICU) admission and hospital length of stay (LOS).On unadjusted analysis, rates of ICU admission were significantly lower in the bolus vs infusion and combination groups (48.4% vs 68.7% vs 83%, respectively; P<.0001) and median LOS (interquartile range) was shorter (3.7 [2.5-6.2 days]) compared with infusion (4.7 [2.9-7.1 days]) and combination (5.0 [2.9-6.7 days]) groups; P=.02. Starting the infusion at ≥ 80 mcg/min produces rapid effects in many patients, and can be titrated higher as… Caveats were that this was in markedly hypertensive patients (all 180s/110s), most of whom had an EF 30-35%, and most patients were African-American, which affects generalizability. The induction of anesthesia was done with thiopentone sodium 5 mg/kg and fentanyl 2 μg/kg, followed by vecuronium 0.1 mg/kg intravenously. Intravenous bolus nitroglycerin has been used routinely in our cardiac catheterization laboratory during the past three years. 2017 Jan;35(1):126-131. doi: 10.1016/j.ajem.2016.10.038. For the most updated list of ABA Keywords and definitions go to Electronic address: The purpose of this study was to compare health care resource utilization among patients who were given intravenous nitroglycerin for acute heart failure (AHF) in the emergency department (ED) by intermittent bolus, continuous infusion, or a combination of both.We retrospectively identified 395 patients that received nitroglycerin therapy in the ED for the treatment of AHF over a 5-year period. Observations on more than 1500 patients suggest that in the supine properly hydrated patient intravenous nitroglycerin produces an initial rapid fall in arterial pressure (systolic, diastolic, and mean). First-line agent in virtually all instances of myocardial ischemia. Patients that received intermittent bolus (n=124) were compared with continuous infusion therapy (n=182) and combination therapy of bolus and infusion (n=89). Daneben wird es auch als Arzneistoff mit gefäßerweiternder Wirkung eingesetzt. The anesthetic procedure was identical to case 1. Nitroglycerine was started as infusion without any bolus dose. Epub 2016 Oct 18.1Department of Pharmacy Services, Detroit Receiving Hospital/Detroit Medical Center, Detroit, MI 48201.2Department of Emergency Medicine and Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, MI 48201.3Department of Emergency Medicine and Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, MI 48201. Dose-Dependent effects of NTG Low dose (< 150 ucg/min): venodilation Higher doses (> 150 ucg/min): arteriolar vasodilationNTG affects the pulmonary vasculature as well, causing Note that the effective dose of NTG may vary substantially, ranging from 5 to 600 ucg/min.Very short-acting, with resolution within 5 minutes.OpenAnesthesia™ content is intended for educational purposes only and not intended as medical advice.Reuse of OpenAnesthesia™ content for commercial purposes of any kind is prohibited. May need 10-12 hr/day nitrate-free interval to avoid tolerance development. Before the endograft was deployed (Excluder 34 × 15; Prograft Medical Inc), 200 μg of nitroglycerin was given, and the mean arterial pressure fell to 61 mm Hg. For pulmonary edema in the ED, NTG is often administered as a sublingual tablet and/or IV infusion. Der Stoff fällt in den Geltungsbereich des Sprengstoffgesetzes und wird in der Anlage II in die Stoffgruppe A eingeteilt. Use of intubation (bolus [8.9%] vs infusion [8.8%] vs combination [16.9%]; P=.096) and bilevel positive airway pressure (bolus [26.6%] vs infusion [20.3%] vs combination [29.2%]; P=.21) were similar as was the incidence of hypotension, myocardial injury, and worsening renal function.In ED patients with AHF, intravenous nitroglycerin by intermittent bolus was associated with a lower ICU admission rate and a shorter hospital LOS compared with continuous infusion.Copyright © 2016 Elsevier Inc. All rights reserved.
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