Acute Pulmonary Oedema Flashcards
(16 cards)
Recite the APO CPG
What condition does this CPG apply to?
Symptomatic cardiogenic pulmonary oedema
CPG refers to Clinical Practice Guidelines.
What is the first-line GTN dose if SBP > 100 mmHg?
GTN 600 mcg S/L.
When is GTN 300 mcg S/L used instead?
If no prior GTN use, or patient is < 60 kg, elderly, borderline BP, or frail.
How often can GTN doses be repeated?
Every 5 minutes, titrated to pain or side effects.
What is the GTN patch dose and where is it applied?
GTN patch 50 mg (0.4 mg/hr) to upper torso/arms.
When should the GTN patch be removed?
If BP falls < 100 mmHg.
What CPAP setting should be applied initially?
CPAP 10 cmH₂O.
What should you be prepared to do during CPAP use?
Suction and assist ventilation if required.
What are the initial BiPAP NIV settings?
• IPAP 10 cmH₂O
• EPAP 5 cmH₂O
• FiO₂ 1.0.
What are the BiPAP adjustments if no improvement?
Increase to: IPAP 15 cmH₂O and EPAP 10 cmH₂O.
What should you do if BiPAP adjustments are still ineffective?
Consult for further guidance.
How should oxygen be titrated once treatment is working?
Titrate FiO₂ to 92–96%.
When should diuretics be considered?
Once normotension or hypertension has resolved.
What diuretic dose is used?
Furosemide 20–40 mg IV or patient’s usual daily dose (max 100 mg IV single dose).
What is the definition and pathophysiology for APO
Acute Pulmonary Oedema is a rapid accumulation of fluid in the alveoli of the lungs, most commonly due to left ventricular failure. This fluid impairs gas exchange and causes sudden shortness of breath, hypoxia, and respiratory distress.
🩺 Common Causes:
Acute myocardial infarction (AMI)
Hypertensive crisis
Valve disease (e.g., mitral stenosis/regurgitation)
Arrhythmias (e.g., AF with RVR)
Fluid overload (e.g., renal failure)
