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急性心力衰竭的急诊处理包括注射速尿和阿片制剂。使用速尿的理由是其具有利尿作用和血管扩张作用。但早期的研究认为心肌梗塞(MI)引起的严重左室衰竭不宜采用速尿治疗。 关于急性左室衰竭的非对照研究显示,静注速尿可降低左右心室充盈压,并引起心率加快,体循环血管阻力增加和每搏量减低。Biagi等报告速尿减轻肺郁血的疗效发生于利尿作用开始前数小时。MI后48h内发生心衰的患者静注速尿40～80mg,虽然有房压力仅降低1mmHg,而肺动脉楔压在5min内降低了3.4mmHg,15min后降至0,30min
Emergency treatment of acute heart failure includes injection of furosemide and opiates. The reason for using furosemide is that it has diuretic and vasodilating effects. However, early studies suggested that myocardial infarction (MI) caused by severe left ventricular failure should not be treated with furosemide. An uncontrolled study of acute left ventricular failure shows that intravenous furosemide reduces left and right ventricular filling pressures and causes an increase in heart rate, increased systemic vascular resistance, and reduced stroke volume. Biagi and other reports of furosemide reduce pulmonary blood flow in the efficacy of diuretic effect occurs a few hours before the start. MI occurred within 48h after MI in patients with intravenous furica 40 ~ 80mg, although room pressure decreased only 1mmHg, and pulmonary artery wedge pressure in 5min decreased by 3.4mmHg, 15min to 0,30min