Alasdair Gray
Diuretic, opiate and nitrate use in severe acidotic acute cardiogenic pulmonary oedema: Analysis from the 3CPO trial
Gray, Alasdair; Goodacre, Steve; Seah, M.; Tilley, S.
Authors
Steve Goodacre
M. Seah
S. Tilley
Abstract
Background: Drug treatments for acute cardiogenic pulmonary oedema (ACPO) have not been rigorously evaluated and recent observational data suggests some agents are related to poorer outcome. Aim: We aimed to examine the effect of treatment with diuretics, nitrates and opiates on 7-day mortality, acidosis and respiratory distress in UK Emergency Department (ED) patients with severe acidotic pulmonary oedema. Design: Analysis of data from the 3CPO trial; a multicentre randomized controlled trial. Methods: Data were analysed from patients recruited with severe acidotic pulmonary oedema to the 3CPO trial in 26 UK EDs between 2003 and 2007. The effects of these treatments on 7-day mortality, improvement in acidosis (pH change between baseline and 1 h) and improvement in respiratory distress (patient measured breathlessness using a Visual Analogue Score between baseline and 1 h) were tested using univariate logistic regression analysis, and a regression model used to adjust for confounding baseline differences. Results: Nitrates were given to 947/1048 (90.4%) patients, diuretics to 934/1049 (89.0%) patients and opiates to 541/1052 patients (51.4%). Adjusted analysis showed that opiate treatment was associated with less improvement in acidosis [difference in improvement in pH -0.022, 95% confidence interval (CI) -0.014 to -0.030, P
Journal Article Type | Article |
---|---|
Publication Date | May 28, 2010 |
Deposit Date | Feb 11, 2011 |
Journal | QJM |
Print ISSN | 1460-2725 |
Electronic ISSN | 1460-2393 |
Publisher | Oxford University Press (OUP) |
Peer Reviewed | Peer Reviewed |
Volume | 103 |
Issue | 8 |
Pages | 573-581 |
DOI | https://doi.org/10.1093/qjmed/hcq077 |
Keywords | diuretic, opiate, nitrate, acidotic, acute cardiogenic pulmonary oedema, 3CPO trial |
Public URL | https://uwe-repository.worktribe.com/output/979339 |
Publisher URL | http://dx.doi.org/10.1093/qjmed/hcq077 |
Contract Date | Dec 2, 2016 |
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