1/ #tweetorial
💠 Beyond Diuresis – Treatment Adjuncts in Cardiogenic Pulmonary Edema.
➡️ Diuretics have traditionally been a mainstay of therapy for cardiogenic pulmonary edema.
manualofmedicine.com
#meded #foamed #medtwitter #cardiotwitter #cardioed
💠 Beyond Diuresis – Treatment Adjuncts in Cardiogenic Pulmonary Edema.
➡️ Diuretics have traditionally been a mainstay of therapy for cardiogenic pulmonary edema.
manualofmedicine.com
#meded #foamed #medtwitter #cardiotwitter #cardioed
2/
➡️ Diuretics may not be the preferred initial therapy for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic.
➡️ Diuretics may not be the preferred initial therapy for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic.
3/
➡️ In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.
➡️ In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.
4/
➡️ Early use of NPPV significantly reduces rates of intubation and inhospital mortality.
➡️ NPPV decreases preload and afterload by increasing intrathoracic pressure.
➡️ Early use of NPPV significantly reduces rates of intubation and inhospital mortality.
➡️ NPPV decreases preload and afterload by increasing intrathoracic pressure.
5/
➡️ Nitrates should be administered early and rapidly to maximize preload and afterload reduction.
➡️ At low doses, nitrates dilate the venous system and reduce preload.
➡️ At higher doses, nitrates produce arterial dilation with resultant afterload reduction.
➡️ Nitrates should be administered early and rapidly to maximize preload and afterload reduction.
➡️ At low doses, nitrates dilate the venous system and reduce preload.
➡️ At higher doses, nitrates produce arterial dilation with resultant afterload reduction.
6/
➡️ Sodium nitroprusside is an alternative that may be useful in patient’s refractory to nitroglycerin therapy
➡️ For patients presenting with pulmonary edema secondary to cardiogenic shock, an inotrope such as dobutamine should be initiated to improve cardiac output.
➡️ Sodium nitroprusside is an alternative that may be useful in patient’s refractory to nitroglycerin therapy
➡️ For patients presenting with pulmonary edema secondary to cardiogenic shock, an inotrope such as dobutamine should be initiated to improve cardiac output.
7/
➡️ Recent data suggest worse outcomes with the use of morphine for cardiogenic pulmonary edema.
➡️ Diuretic administration should follow the use of more rapidly acting preload and afterload reducing therapies, particularly if there is little suspicion of volume overload.
➡️ Recent data suggest worse outcomes with the use of morphine for cardiogenic pulmonary edema.
➡️ Diuretic administration should follow the use of more rapidly acting preload and afterload reducing therapies, particularly if there is little suspicion of volume overload.
جاري تحميل الاقتراحات...