Acutely decompensated congestive heart failure is a common presentation of patients presenting to the emergency department. Typically these patients present with shortness of breath and significant pulmonary edema. Traditionally the initial treatment in such patients has consisted of intravenous diuretics (1). This has been the mainstay of treatment for decades but may not be the most effective means of treating these patients (2). For a condition that accounts for 800,000 emergency department visits per year, it is surprising that so little research has been done in the recent years regarding the most effective treatment for acute decompensated heart failure (1). The persistent theory that the first line treatment for these…show more content… The main outcomes evaluated involve the efficacy and safety of each drug used.
The University of Texas Rio Grande Valley Library web site was accessed for collection of articles pertaining to the subject matter listed above. Under the heading of ‘Articles & Databases’ the Science Direct Library and Pub Med was opened. Entering the key-words “acute pulmonary edema”, “high-dose nitroglycerin” and “furosemide”, a search of both databases was conducted. The Science Direct library returned 204 articles all written within the past six years. Of these, the articles were reviewed based on the titles and 40 were selected for review. The abstracts were then read to determine the relevance to the topics in question. 16 articles were deemed relevant to the topic selected and deemed appropriate for review. Pub Med recovered over 100 articles but access to these articles proved difficult and required secondary subscriptions, so the articles from Science Direct were used instead. The full publication of each of the 16 selected articles was printed out from Science Direct and the chosen articles were read with great detail and and pertinent data was selected from each one for inclusion in this review paper.
Multiple studies have shown that high dose nitrates are superior to furosemide in the treatment of acutely decompensated heart failure (5, 6, 7, 8). Mattu et al