Pulmonary edema - Revision history

Danbot: Add MedicationDose entries (nitroglycerin, furosemide) with SMW annotations

2026-03-20T18:32:53Z

Add MedicationDose entries (nitroglycerin, furosemide) with SMW annotations

@@ Línea 41: / Línea 41: @@
 *After patient improves, titrate down [[nitroglycerin]] as [[enalaprilat]] (0.625 - 1.25mg IV) or [[captopril]] are started
 *Morphine is no longer recommended due to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>
 ==Disposition==

Borzi: /* Management */

2021-09-08T00:15:50Z

Management

← Revisión anterior		Revisión del 00:15 8 sep 2021
Línea 40:		Línea 40:
	*If [[nitroglycerin]] fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)		*If [[nitroglycerin]] fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)
	*After patient improves, titrate down [[nitroglycerin]] as [[enalaprilat]] (0.625 - 1.25mg IV) or [[captopril]] are started		*After patient improves, titrate down [[nitroglycerin]] as [[enalaprilat]] (0.625 - 1.25mg IV) or [[captopril]] are started
	*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>		*Morphine is no longer recommended due to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>

	==Disposition==		==Disposition==

Rossdonaldson1: /* See Also */

2021-03-11T16:52:39Z

ClaireLewis: /* Management */

2019-10-13T14:37:30Z

Management

← Revisión anterior		Revisión del 14:37 13 oct 2019
Línea 39:		Línea 39:
	****Generally start IV nitroglycerin 50mcg/min and titrate rapidly (150mcg/min or higher) to symptom relief as long as patient's blood pressure tolerates		****Generally start IV nitroglycerin 50mcg/min and titrate rapidly (150mcg/min or higher) to symptom relief as long as patient's blood pressure tolerates
	*If [[nitroglycerin]] fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)		*If [[nitroglycerin]] fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)
	*After patient improves, titrate down [[nitroglycerin]] as [[~~enaliprilat~~]] (0.625 - 1.25mg IV) or [[captopril]] are started		*After patient improves, titrate down [[nitroglycerin]] as [[enalaprilat]] (0.625 - 1.25mg IV) or [[captopril]] are started
	*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>		*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>

ClaireLewis at 15:10, 26 September 2019

2019-09-26T15:10:09Z

← Revisión anterior		Revisión del 15:10 26 sep 2019
Línea 31:		Línea 31:

	==Management==		==Management==
	*CPAP/~~BPAP~~ with PEEP 6-8; titrate up to PEEP of 10-12		*CPAP/[[BiPAP]] with PEEP 6-8; titrate up to PEEP of 10-12
	*Nitroglycerin		*[[Nitroglycerin]]
	**Dosing Options		**Dosing Options
	***Sublingual 0.4mg q5min		***Sublingual 0.4mg q5min
	***Nitropaste (better bioavailability than oral Nitroglycerin)		***Nitropaste (better bioavailability than oral Nitroglycerin)
	***Intravenous: 0.1mcg/kg/min - 5mcg/kg/min		***Intravenous: 0.1mcg/kg/min - 5mcg/kg/min
	****Generally start IV ~~Nitroglycerin~~ 50mcg/min and titrate rapidly (150mcg/min or higher) to symptom relief as long as patient's blood pressure tolerates		****Generally start IV nitroglycerin 50mcg/min and titrate rapidly (150mcg/min or higher) to symptom relief as long as patient's blood pressure tolerates
	*If [[nitroglycerin]] fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)		*If [[nitroglycerin]] fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)
	*After patient improves, titrate down [[nitroglycerin]] as enaliprilat (0.625 - 1.25mg IV) or captopril are started		*After patient improves, titrate down [[nitroglycerin]] as [[enaliprilat]] (0.625 - 1.25mg IV) or [[captopril]] are started
	*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>		*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>

Rossdonaldson1: /* Evaluation */

2019-07-20T13:13:19Z

Evaluation

← Revisión anterior		Revisión del 13:13 20 jul 2019
Línea 28:		Línea 28:

	{{BNP value}}		{{BNP value}}
			{{Lung ultrasound pulmonary edema}}

	==Management==		==Management==

Rossdonaldson1: Text replacement - "Troponin" to "Troponin"

2019-07-01T20:38:19Z

Text replacement - "*Troponin" to "*Troponin"

← Revisión anterior		Revisión del 20:38 1 jul 2019
Línea 22:		Línea 22:
	**Alveolar edema		**Alveolar edema
	**Cardiomegaly		**Cardiomegaly
	*Troponin +/- BNP		*[[Troponin]] +/- BNP
	*[[Ultrasound]]		*[[Ultrasound]]
	**Bedside to assess [[Cardiac ultrasound\|global function]], [[Ultrasound: lungs\|B lines]], [[IVC ultrasound\|assessment of IVC]]		**Bedside to assess [[Cardiac ultrasound\|global function]], [[Ultrasound: lungs\|B lines]], [[IVC ultrasound\|assessment of IVC]]

Rossdonaldson1: Text replacement - " NTG " to " nitroglycerin "

2019-03-30T15:30:49Z

Text replacement - " NTG " to " nitroglycerin "

← Revisión anterior		Revisión del 15:30 30 mar 2019
Línea 37:		Línea 37:
	***Intravenous: 0.1mcg/kg/min - 5mcg/kg/min		***Intravenous: 0.1mcg/kg/min - 5mcg/kg/min
	****Generally start IV Nitroglycerin 50mcg/min and titrate rapidly (150mcg/min or higher) to symptom relief as long as patient's blood pressure tolerates		****Generally start IV Nitroglycerin 50mcg/min and titrate rapidly (150mcg/min or higher) to symptom relief as long as patient's blood pressure tolerates
	*If ~~NTG~~ fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)		*If [[nitroglycerin]] fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)
	*After patient improves, titrate down ~~NTG~~ as enaliprilat (0.625 - 1.25mg IV) or captopril are started		*After patient improves, titrate down [[nitroglycerin]] as enaliprilat (0.625 - 1.25mg IV) or captopril are started
	*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>		*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>

SLuckettG: /* Disposition */

2019-03-08T00:40:48Z

Disposition

← Revisión anterior		Revisión del 00:40 8 mar 2019
Línea 42:		Línea 42:

	==Disposition==		==Disposition==
			*Depends on underlying cause, hemodynamic stability, and response to treatment

	==See Also==		==See Also==

SLuckettG: /* Management */

2019-03-08T00:38:04Z

Management

← Revisión anterior		Revisión del 00:38 8 mar 2019
Línea 30:		Línea 30:

	==Management==		==Management==
	*CPAP/~~BiPAP~~ with PEEP 6-8; titrate up to PEEP of 10-12		*CPAP/BPAP with PEEP 6-8; titrate up to PEEP of 10-12
	*Nitroglycerin		*Nitroglycerin
	**Dosing Options		**Dosing Options
Línea 36:		Línea 36:
	***Nitropaste (better bioavailability than oral Nitroglycerin)		***Nitropaste (better bioavailability than oral Nitroglycerin)
	***Intravenous: 0.1mcg/kg/min - 5mcg/kg/min		***Intravenous: 0.1mcg/kg/min - 5mcg/kg/min
	****Generally start IV Nitroglycerin 50mcg/min and titrate rapidly (150mcg/min or higher) to symptom relief		****Generally start IV Nitroglycerin 50mcg/min and titrate rapidly (150mcg/min or higher) to symptom relief as long as patient's blood pressure tolerates
	****Nursing may be resistant. Explain that 1 SL tab (400 mcg) Q4min = 100 mcg/min for perspective.		*If NTG fails to reduce work of breathing, consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)
	*If NTG fails to reduce BP consider nitroprusside (reduces both preload and afterload) or ACE-inhibitiors (preload reducer)		*After patient improves, titrate down NTG as enaliprilat (0.625 - 1.25mg IV) or captopril are started
	*After patient improves titrate down NTG as enaliprilat (0.625 - 1.25mg IV) or captopril are started
	*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>		*Morphine is no longer recommended do to increased morbidity<ref>Peacock WF, Hollander JE, Diercks DB, Lopatin M, Fonarow G, Emerman CL. Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis. Emerg Med J. 2008 Apr;25(4):205-9.</ref><ref>Ellingsrud C, Agewall S. Morphine in the treatment of acute pulmonary oedema--Why? Int J Cardiol. 2016 Jan 1;202:870-3.</ref>

← Revisión anterior		Revisión del 16:52 11 mar 2021
Línea 46:		Línea 46:

	==See Also==		==See Also==
	*[[Congestive ~~Heart Failure (CHF)~~]]		*[[Congestive heart failure]]
	*[[Acute Respiratory Distress Syndrome]]		*[[Acute Respiratory Distress Syndrome]]
	*[[~~Sympathetic crashing acute~~ pulmonary edema ~~(SCAPE)~~]]		*[[Flash pulmonary edema]]

	==References==		==References==

Pulmonary edema - Revision history

Danbot: Add MedicationDose entries (nitroglycerin, furosemide) with SMW annotations

Borzi: /* Management */

Rossdonaldson1: /* See Also */

ClaireLewis: /* Management */

ClaireLewis at 15:10, 26 September 2019

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: Text replacement - "*Troponin" to "*Troponin"

Rossdonaldson1: Text replacement - " NTG " to " nitroglycerin "

SLuckettG: /* Disposition */

SLuckettG: /* Management */

Rossdonaldson1: Text replacement - "Troponin" to "Troponin"