Can anyone offer some advice about the use of salbutamol to treat
bronchospasm in cases of acute cardiogenic pulmonary oedema?
At least one ambulance protocol I am familiar with suggests that nebulised
salbutamol is appropriate to use when a patient with suspected cardiogenic
pulmonary oedema presents with a wheeze. In fact the protocol even mentions
that very dated term "cardiac asthma" to describe this presentation. My
question is whether anyone has an opinion about the use of this drug in a
case such as this where cardiac failure is probably responsible for
decreased cardiac output and high pulmonary capillary pressure. Would the
beta 1 effect that is often seen following salbutamol administration have a
potentially adverse effect on cardiac function and hence oedema formation?
Wouldn't PEEP and GTN be more appropriate?
Bill Lord
Lecturer, School of Public Health
Charles Sturt University
Bathurst NSW 2795
Australia
Tel: 61 2 63384546
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