A systematic review that included one prospective and four retrospective studies of opiates (morphine or diamorphine) in ADHF found that the available evidence was very low quality, with no evidence of benefit and some evidence of harm [14]. The largest of the studies found that morphine administration for ADHF was associated with increased frequency of mechanical ventilation, admission to an intensive care unit, and in-hospital mortality [24]. After risk adjustment and exclusion of ventilated patients, morphine remained an independent predictor of mortality (OR 4.8, 95% CI 4.52-5.18). Two smaller studies found no significant differences in mortality rates with opiate therapy. Although risk adjustment in the largest study may not have been adequate, the results raise concern about the safety of opiate therapy in this population.
حضرتك يا دكتر ف الدقيقة ٢٣ ذكرت ان العيان لو ضغطه اقل من ٨٥ هديله non vasodilating inotropes و قولت مثال عليه dobutamine هو مش ال dobutamine يعتبر vd لكن norepinephrine هو اللى vc ?
أسلوبك سهل ومعلومات قيمه... جزاك الله خيرا
Very Good but The new guidelines do not support the use of opiate in acute
heart failure
اكتر من رائع والله
A systematic review that included one prospective and four retrospective studies of opiates (morphine or diamorphine) in ADHF found that the available evidence was very low quality, with no evidence of benefit and some evidence of harm [14]. The largest of the studies found that morphine administration for ADHF was associated with increased frequency of mechanical ventilation, admission to an intensive care unit, and in-hospital mortality [24]. After risk adjustment and exclusion of ventilated patients, morphine remained an independent predictor of mortality (OR 4.8, 95% CI 4.52-5.18). Two smaller studies found no significant differences in mortality rates with opiate therapy. Although risk adjustment in the largest study may not have been adequate, the results raise concern about the safety of opiate therapy in this population.
Tnx Dr
جزاك الله خير محاضره مفيده
حضرتك يا دكتر ف الدقيقة ٢٣
ذكرت ان العيان لو ضغطه اقل من ٨٥ هديله non vasodilating inotropes و قولت مثال عليه dobutamine
هو مش ال dobutamine يعتبر vd
لكن norepinephrine هو اللى vc ?
dobutamine and dopamine can be both non dilating and dilating inotrope agents , it depends on the dose used