Emergency therapy for pulmonary edema

Treatment (scheme of emergency therapy of cardiogenic pulmonary edema)

It is convenient for practical use of the scheme of emergency therapy of cardiogenic pulmonary edema, which is based on two clinical indicators: the level of arterial pressure and the degree of congestive changes in the lungs (V. Rukins, 1994).

The scheme provides six options:

I. Normal blood pressure and moderate changes in the lungs: sitting position, nitroglycerin under the tongue repeatedly, lasix intramuscularly or intravenously, diazepam inside or intramuscularly, oxygen therapy;

II. Normal blood pressure and pronounced changes in the lungs: sitting position, nitroglycerin under the tongue and intravenously, intravenous lazix, morphine or diazepam intravenously fractional, oxygen therapy, positive end-expiratory pressure, antifoam;

III. Increased blood pressure and moderate changes in the lungs: sitting position, nitroglycerin under the tongue repeatedly, clonidine intravenously or pentamine intravenously drip, intravenous intravenous diazepam, intramuscular or intravenous diazepam, antifoam;

IV. Increased blood pressure and pronounced changes in the lungs: sitting position, nitroglycerin under the tongue, sodium nitroprusside or nitroglycerin intravenously drip, intravenous lasix, oxygen therapy, positive end-expiratory pressure, antifoam;

V. Low blood pressure and moderate changes in the lung: lying position, dobutamine intravenously drip(systolic blood pressure rises gradually to 90-95 mm Hg), intravenous lasix (after stabilization of arterial pressure), oxygen therapy;

VI. sharply reduced blood pressure and pronounced changes in the lungs: lying position, dopamine intravenously drip(systolic blood pressure rises gradually to 90-95 mm Hg If arterial hypertension is not corrected by dopamine, additionally intravenously drip norepinephrine is prescribed), intravenous intravenously (after stabilization of arterial pressure), nitroglycerin is intravenously drip (in addition to dopamine, if in the process of stabilizing blood pressure keeps or increases pulmonary edema), oxygen therapy and defoaming.