[Shall we Follow the Guidelines for Isosorbide Dinitrate in Acute Pulmonary Edema?]

Therapie. 2015 May-Jun;70(3):265-71. doi: 10.2515/therapie/2014226. Epub 2015 Apr 16.
[Article in French]

Abstract

Purpose: Prospective evaluation of short (dyspnoea) and mid-term outcomes in 47 consecutive patients admitted in the intensive care unit for acute pulmonary edema treated on a liberal basis.

Results: Patients were elderly (83 year-old) and 60% had preserved left ventricular ejection fraction (>50%). Dyspnoea assessed by visual analogue score was weakly associated with treatment posology. Despite low use of inotropes (6%) and intubation (9%), hospital and D90 mortality was high (19% and 32% respectively). Higher mortality was noticed in patients receiving no isosorbide dinitrate (p = 0.04). In the multivariate analysis, only age and delta brain natriuretic peptide (difference between BNP on D1 and D0) remained significantly associated with mortality on D90 (OR 1.13; p = 0.03 and OR 1.004; p = 0.04 respectively).

Conclusion: Acute pulmonary edema carried a dramatic in-hospital and mid-term mortality in our elderly patients. Isosorbide dinitrate was associated with decreased D90 mortality but not in the multivariate analysis.

Publication types

  • English Abstract

MeSH terms

  • Acute Disease
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Dyspnea / drug therapy
  • Hospital Mortality
  • Humans
  • Isosorbide Dinitrate / therapeutic use*
  • Male
  • Multivariate Analysis
  • Natriuretic Peptide, Brain / metabolism
  • Practice Guidelines as Topic*
  • Prospective Studies
  • Pulmonary Edema / drug therapy*
  • Pulmonary Edema / mortality
  • Treatment Outcome
  • Vasodilator Agents / therapeutic use*
  • Ventricular Function, Left

Substances

  • Vasodilator Agents
  • Natriuretic Peptide, Brain
  • Isosorbide Dinitrate