Circulatory System
Conditions
Interventions
NTG in intermittent bolus
NTG continuous infusion
Sponsors
Cardiology department at Benha faculty of medicine in Benha University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. All adult patients presenting to the ED of either study site with hyper-tensive AHF. 2. The diagnosis of hypertensive AHF will be clinical and based on the presence of pulmonary rales, a portable chest radiograph determined by the treating physician to be consistent with pulmonary edema, and 1 or more of the following: a history of heart failure, tach-ypnea (respiratory rate [RR] > 30 breaths/min), significant dyspnea (use of accessory muscles of respiration or obvious air hunger), and significant hypoxia (defined as oxygen saturation [SpO2] < 90% on room air or < 95% on supplemental oxygen) or hypoxemia (partial pressure of arterial oxygen [PaO2] < 50 mm Hg on room air). 3. Ability to obtain written informed consent from the patient or a close family member.
Exclusion criteria
Exclusion criteria: Any of the following: 1. Noncardiogenic pulmonary edema, requirement for immediate intubation or cardiopulmonary resuscitation, 2. Inability to obtain informed consent because of alteration in cognition or consciousness or no family or alternative consenting source available 3. Known or suspected pregnancy 4. Acute ST-segment elevation myocardial infarction. 5. Suspected right-sided ventricular ischemia (ST segment depression or new T-wave inversions in leads V1 or V2) 6. Known sensitivity or intolerance to sublingual, transdermal, or intravenous nitroglycerin.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The requirement for endotracheal intubation ;Primary SAFETY outcome: 1. development of either neurologic complications (defined as presence of any new speech, sensory, or movement deficits de-fined as a transient ischemic attacks or stroke on clinical grounds or by subsequent computed tomography of the brain) or 2. cardiovascular complications, defined as hypotensive epi-sodes requiring intervention or the incidence of acute myocardi-al injury (defined as rise of Troponin level by at least 0.25 ng/ml). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. need for ICU admission, 2. Need for BiPAP 3. total hospital length of stay, 3. worsening of renal dysfunction (as determined by increase in serum creatinine level > 0.5 mg/dL). | — |
Countries
Egypt
Contacts
Public ContactAhmed Bendary
Lecturer of Cardiology at Benha Faculty of medicine in Benha University
Outcome results
None listed