Follow-up the haemodynamic effect of nitroglycerin and determination of the optimal dose using the non-invasive and invasive methods in patients treated at the intensive care unit.

The authors report on observations with nitroglycerin applied in the treatment of acute and chronic left ventricular failure to patients suffering from ischaemic heart disease and acute myocardial infarction. The treatment of 28 patients was discussed in detail, the nitroglycerin products used were: Nitrolingual inj. Nitromint controlled-release tabl., Nitrong tablet and Iso-Mack controlled-release tablet (isosorbide dinitrate). The haemodynamism-influencing effects of nitroglycerin were controlled by the invasive and non-invasive methods. The pulse volume of the left ventricle was estimated by measuring the ejection angle, the filling pressure of the left ventricle by measuring the diastolic pressure of the pulmonary artery. On the basis of their observations the authors attach high importance to the determination of individual nitroglycerin doses of broader spectrum compared to the commonly used doses. By taking into consideration the ejection angle correlating closely with left ventricular pulse volume besides the other characteristic parameters (PCWP, RR, pulse rate, ECG), higher nitroglycerin doses could be used without risk in cases in which the survival of the patient was obviously due to the application of higher doses.