"Optimizing Nitroglycerin Dosage: The Case for High Doses"
A recent randomized controlled trial compared high dose intravenous nitroglycerin to low dose for treating sympathetic crashing acute pulmonary edema (SCAPE) and found that high dose nitroglycerin resulted in significantly improved outcomes, with 65% of patients experiencing symptom resolution at 6 hours compared to 12% in the low dose group. The study, although small and single-center, suggests that higher doses of nitroglycerin may be more effective in managing SCAPE, potentially prompting a change in practice while awaiting larger studies.
