• Am J Emerg Med · Jun 2021

    Case Reports

    High-dose nitroglycerin infusion for the management of sympathetic crashing acute pulmonary edema (SCAPE): A case series.

    • Krisi Stemple, Kyle M DeWitt, Blake A Porter, Michael Sheeser, Eike Blohm, and Mark Bisanzo.
    • Department of Pharmacy, The University of Vermont Medical Center, United States of America. Electronic address: stemplekristina@gmail.com.
    • Am J Emerg Med. 2021 Jun 1; 44: 262-266.

    AbstractSympathetic crashing acute pulmonary edema (SCAPE) describes the most severe presentation of acute heart failure (AHF). Immediate intervention is required to prevent hemodynamic decompensation and endotracheal intubation. Although high-dose nitroglycerin (>100 μg/min) has been described for this clinical scenario in limited case reports, the concern for adverse effects such as hypotension and syncope limit providers comfortability in initiating nitroglycerin at these doses. Described here is a case series of four patients who safely and effectively received high-dose nitroglycerin infusions for the management of SCAPE.Copyright © 2020 Elsevier Inc. All rights reserved.

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