This study aims to understand how nitroglycerin affects patients with acute heart failure, a condition where the heart struggles to pump blood effectively, leading to fluid buildup and breathing difficulties. Nitroglycerin relaxes blood vessels to ease the heart's workload and may help reduce fluid buildup. The investigators hypothesize that nitroglycerin can increase blood flow from the heart and promote urine production, which may reduce congestion in AHF patients. By studying heart function, blood volume, and fluid levels during treatment, the goal is to identify which patients may benefit most from nitroglycerin therapy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
21
Infusion of intravenous nitroglycerin beginning at 2 microgram/kg/min (2 ml/hour) and titrated with the aim of a MAP reduction of 20-30%. Infusion rate will not be increased after the first 30 minutes and is limited to 0.1 µg/kg/min to 5 µg/kg/min.
Stroke volume
Change in stroke volume (obtained from LiDCO) from baseline through vasodilation period.
Time frame: From initiation of nitroglycerin infusion at time zero until study termination at 180 minutes.
Cumulated urinary output (mL)
Measurement of cumulated urinary output after placement of a transurethral catheter.
Time frame: From time zero until study termination at 180 minutes.
Mean arterial blood pressure
Time frame: From time zero throughout the study period until termination at time 180 minutes.
Heart rate
Time frame: From time zero throughout the study period until termination at time 180 minutes.
Cardiac output
Measured by echocardiography.
Time frame: At baseline and at timepoints 90 minutes and 180 minutes.
Peripheral perfusion index
As obtained by photoplethysmography, where a higher numerical value may indicate better peripheral tissue perfusion.
Time frame: From time zero throughout the study period until termination at time 180 minutes.
Systemic vascular resistance
\[SVR=(MAP-RAP)×80/CO\]
Time frame: From time zero throughout the study period until termination at time 180 minutes.
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