Journal article
Rapid improvement of acute pulmonary edema with sublingual captopril
Academic emergency medicine, v 3(3), pp 205-212
Mar 1996
PMID: 8673775
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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 O2, 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 O2, nitrates, morphine, and furosemide produces more rapid clinical improvement than does the standard regimen alone.
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Details
- Title
- Rapid improvement of acute pulmonary edema with sublingual captopril
- Creators
- R. J. Hamilton - New York UniversityW. A. Carter - New York UniversityE. J. Gallagher - Albert Einstein College of Medicine
- Publication Details
- Academic emergency medicine, v 3(3), pp 205-212
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:A1996TX51300007
- Scopus ID
- 2-s2.0-0029876913
- Other Identifier
- 991022157204404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Emergency Medicine