Good Call wanted to share

[usalsfyre]

I'm curious, what's your opinion on giving NTG in an RVI if you provide a fluid bolus first to increase preload?

NTG has very little affect on the coronary vasculature, the primary way it helps with CP is by lowering MvO2 by reducing preload. Since RVIs tend to be preload dependent anyway, to me raising preload to then turn around and lower it is more than a little pointless.

Last publication from the American College of Cardiology I saw said omit NTG in RVI. This was last year when I was revising protocols. I think it's probably just one of those holdovers from yesteryear.

 

[fast65]

NTG has very little affect on the coronary vasculature, the primary way it helps with CP is by lowering MvO2 by reducing preload. Since RVIs tend to be preload dependent anyway, to me raising preload to then turn around and lower it is more than a little pointless.

Last publication from the American College of Cardiology I saw said omit NTG in RVI. This was last year when I was revising protocols. I think it's probably just one of those holdovers from yesteryear.

Perfect, thanks for the education

 

[tah06090]

Avg transport 30min to 50 min

and ont he NTG intial pressure was 160s/90s so i went with a trial we also had fluids running her pressure stayed steady and the NTG did drop her pain to a 5/10 for a while before it returned.