Rapid Improvement of Acute Pulmonary Edema with Sublingual Captopril

• Richard J. Hamilton

• Wallace A. Carter

• E. John Gallagher

抄録

Objective: To test the hypothesis that sublingual captopril produces a more rapid improvement of acute pulmonary edema (APE) than does placebo, when added to a standard regimen of O 2 , nitrates, morphine, and furosemide. Methods: Prospective, randomized, double‐blind, placebo‐controlled clinical trial in an urban teaching hospital ED. Adults brought to the ED with APE were given captopril or placebo sublingually Every 5 minutes a clinical APE distress score (APEX) was obtained. Results: Over the first 40 minutes of treatment, the mean APEXs were significantly better for the patients given captopril [p < 0. 001, F = 14. 5, one‐way (repeated‐measures) analysis of variance (ANOVA)]. At 30 minutes, the patients given captopril had a mean APEX improvement of 43% (i. e., to 57% of initial distress); the group given the current standard regimen plus placebo improved only 25% (i. e., to 75% of initial distress; p = 0. 03, multiway ANOVA). In addition, there was less respiratory failure necessitating mechanical ventilation in the captopril patients (9%) vs the placebo patients (20%), which did not achieve significance (p = 0. 10, Fisher's exact test). Conclusion: In APE, the addition of sublingual captopril to the standard regimen of O 2 , nitrates, morphine, and furosemide produces more rapid clinical improvement than does the standard regimen alone.

収録刊行物

• Academic Emergency Medicine

  Academic Emergency Medicine 3 (3), 205-212, 1996-03

  Wiley

キーワード

• Emergency Medicine
• General Medicine

詳細情報

• CRID: 1360011143650527616
• NII論文ID: 30040779687
• DOI: 10.1111/j.1553-2712.1996.tb03422.x
• ISSN: 15532712
• ISSN: 10696563
• Web Site: https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fj.1553-2712.1996.tb03422.x
• Web Site: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1553-2712.1996.tb03422.x
• データソース種別:
  • Crossref
  • CiNii Articles