The Resus Room
November 2022; papers of the month
Nov 1, 2022
This podcast covers three interesting topics: challenging guidelines on nitrate administration during myocardial infarction, different blood pressure targets for post cardiac arrest patients, and healthcare professionals' perceptions of interprofessional teamwork in critical incidents.
31:31
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Quick takeaways
- Nitrates may not have a significant negative effect on right ventricular myocardial infarction, challenging current guidelines.
- Targeting specific blood pressure levels may not significantly impact outcomes in comatose survivors of cardiac arrest.
Deep dives
Adverse Events from Nitrate Administration during Right Ventricular Myocardial Infarction: A Systematic Review and Meta-Analysis
The current guidelines recommend against administering nitrates to patients with right ventricular myocardial infarction due to concerns about decreasing preload and reducing cardiac output. However, a systematic review and meta-analysis challenge this recommendation based on evidence from a cohort study of 40 patients. The meta-analysis included over 1,100 patients and found no statistically significant difference in adverse events between patients receiving nitrate administration and those with inferior myocardial infarction. The authors concluded that nitrate administration in right ventricular myocardial infarction may not have a significant negative effect and further studies are needed for clearer guidelines.
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