Nitroglycerine bolus dose and follow by in fusion in emergency department older adults with hypertensive heart failure. Nitroglycerine, older adults, hypertension, heart failure
Conditions
Interventions
Nitroglycerine 1 mg IV bolus and follow by 0.5 ug/kg/min and record the blood pressure from the beginning until 60 minutes. ,Nitroglycerine 0.5 ug/kg/min iv contineous drip and record the blood press
Active Comparator Drug,Active Comparator Drug
Nitroglycerine 1 mg IV bolus and follow by 0.5 ug/kg/min,Nitroglycerine 0.5 ug/kg/min and record the blood pressure from the beginning until 60 minutes.
Sponsors
Navamindradhiraj University Research Fund
Eligibility
Sex/Gender
All
Age
65 Years to 99 Years
Inclusion criteria
Inclusion criteria: 1. Patients over 65 years of age who come to the emergency room of Vajira Hospital 2. The patient was diagnosed with acute heart failure. 3. The patient has a systolic blood pressure greater than 140 mm Hg.
Exclusion criteria
Exclusion criteria: 1. Have a history of allergy to nitroglycerin 2. Brain accident 3. Severe sepsis (SOFA score >=2, lactate >4, and there is evidence of a source of infection contributing to the symptoms that brought the patient to the emergency room). 4. Liver failure or chronic cirrhosis Stage 3-4 (decompensated liver cirrhosis) 5. Chronic renal failure or end-stage renal disease with a glomerular filtration rate (GFR) of less than 15 ml/min/1.73 m 6. ST elevation (STEMI) or right ventricular ischemia (RV infarction). 7. Having a history of drug use phosphodiesterase type 5 (PDE-5) inhibitors, including sildenafil, tadalafil, vardenafil, within 48 hours 8. Having a history of high intracranial pressure such as brain tumors, cerebral hemorrhage and assessed from other associated symptoms, including severe headache, Blurred vision, double vision, convulsions, depression, loss of consciousness, nausea, vomiting, sudden weakness of one limb. 9. Have a history of hypertrophic cardiomyopathy, restrictive cardiomyopathy 10. Have cardiac temponade 11. Chronic pericarditis (constrictive pericarditis) 12. Weighing less than 40 kilograms or more than 100 kilograms
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to first systolic blood pressure less than 140 mmHg 1 hour after received nitroglycerine Blood pressure measurement using Philips - IntelliVue MX400 every 5 minutes until 60 minutes,Delta change of systolic blood pressure 1 hour after received nitroglycerine Blood pressure measurement using Philips - IntelliVue MX400 | — |
Secondary
| Measure | Time frame |
|---|---|
| Accumulation dose of nitroglycerine 1 hour microgram,ICU admission 24 hours rate of ICU admission ,Mortality 30 days rate of mortality ,Intubation 24 hours Intubation rate | — |
Countries
Thailand
Contacts
Public ContactJiraporn Srion
Vajira Hospital, Navamindradhiraj University
Outcome results
None listed