Therapy

Why?

• It is more effective than low-dose isosorbide dinitrate and high-dose frusemide at reducing myocardial infarction and the need for mechanical ventilation. ^a
• There is no clear effect on mortality or adverse events. ^a
• Patients on high-dose isosorbide dinitrate have a greater rise in oxygen saturation (mean of 5%) and a greater fall in respiratory rate (mean of 6 breaths a minute). ^a

Pulmonary oedema: low dose frusemide and high dose nitrates reduce myocardial infarction and the need for ventilation

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
pulmonary oedema a	low-dose furosemide and high-dose nitrates	high-dose furosemide and low-dose nitrates	need for mechanical ventilation at 12 hours	41%	67% (28% to 84%)	4 (2 to 9)
			myocardial infarction at 24 hours	36%	53% (5% to 76%)	5 (3 to 39)