title: [Shall we Follow the Guidelines for Isosorbide Dinitrate in Acute Pulmonary Edema?].
abstract: OBJECTIVE
  Prospective evaluation of short (dyspnoea) and mid-term outcomes in 47 consecutive patients admitted in the intensive care unit for acute pulmonary edema treated on a liberal basis.
  
  
  RESULTS
  Patients were elderly (83 year-old) and 60% had preserved left ventricular ejection fraction (>50%). Dyspnoea assessed by visual analogue score was weakly associated with treatment posology. Despite low use of inotropes (6%) and intubation (9%), hospital and D90 mortality was high (19% and 32% respectively). Higher mortality was noticed in patients receiving no isosorbide dinitrate (p = 0.04). In the multivariate analysis, only age and delta brain natriuretic peptide (difference between BNP on D1 and D0) remained significantly associated with mortality on D90 (OR 1.13; p = 0.03 and OR 1.004; p = 0.04 respectively).
  
  
  CONCLUSIONS
  Acute pulmonary edema carried a dramatic in-hospital and mid-term mortality in our elderly patients. Isosorbide dinitrate was associated with decreased D90 mortality but not in the multivariate analysis.
authors.affiliation: Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Champion
authors.affiliation: Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Deye
authors.affiliation: Service de Cardiologie, Hôpital Lariboisière, Paris, France.
authors.forename: Alain Cohen
authors.initials: AC
authors.lastname: Solal
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000188:drug therapy; D017052:Hospital Mortality; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use*; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*; D016277:Ventricular Function, Left
chemical_list: D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D007548:Isosorbide Dinitrate