Logo image
Back
Hemodynamic Effects of Nitroglycerin Ointment in Emergency Department Patients
Journal article   Open access   Peer reviewed

Hemodynamic Effects of Nitroglycerin Ointment in Emergency Department Patients

Bryn E. Mumma, Kapil R. Dhingra, Charley Kurlinkus and Deborah B. Diercks
The Journal of emergency medicine, v 47(2), pp 192-197
01 Aug 2014
DOI: https://doi.org/10.1016/j.jemermed.2014.01.026
PMID: 24698507
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://escholarship.org/uc/item/25j16574View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

heart failure impedance cardiography nitroglycerin
Nitroglycerin ointment is commonly used in the treatment of emergency department (ED) patients with suspected acute heart failure (AHF) or suspected acute coronary syndrome (ACS), but its hemodynamic effects in this population are not well described. Our objective was to assess the effect of nitroglycerin ointment on mean arterial pressure (MAP) and systemic vascular resistance (SVR) in ED patients receiving nitroglycerin. We hypothesized that nitroglycerin ointment would result in a reduction of MAP and SVR in the acute treatment of patients. We conducted a prospective, observational pilot study in a convenience sample of adult patients from a single ED who were treated with nitroglycerin ointment. Impedance cardiography was used to measure MAP, SVR, cardiac output (CO), stroke volume (SV), and thoracic fluid content (TFC) at baseline and at 30, 60, and 120 min after application of nitroglycerin ointment. Mixed effects regression models with random slope and random intercept were used to analyze changes in hemodynamic parameters from baseline to 30, 60, and 120 min after adjusting for age, sex, and final ED diagnosis of AHF. Sixty-four subjects with mean age of 55 years (interquartile range, 48–67 years) were enrolled; 59% were male. In the adjusted analysis, MAP and TFC decreased after application of nitroglycerin ointment (p = 0.001 and p = 0.043, respectively). Cardiac index, CO, SVR, and SV showed no change (p = 0.113, p = 0.085, p = 0.570, and p = 0.076, respectively) over time. Among ED patients who are treated with nitroglycerin ointment, MAP and TFC decrease over time. However, other hemodynamic parameters do not change after application of nitroglycerin ointment in these patients.

Metrics

9 Record Views
4 citations in Web of Science
6 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Emergency Medicine
Logo image