Beta-Adrenergic Antagonists Improve Oxygen Saturation in Acute Pulmonary Edema: A Case Series in the Prehospital Setting

Abstract

The use of beta-adrenergic antagonists in acute heart failure is controversial. In this case series, we report the use of intravenous atenolol, a short-acting cardioselective beta-adrenergic antagonist, to treat acute pulmonary edema in the prehospital setting. Four patients with a documented history of cardiac disease and one patient with unknown cardiac issues experienced severe respiratory distress and presented with pulmonary edema; the local emergency medical service was utilized. In all of the patients, the saturation of peripheral oxygen (SpO₂) was severely low, and the patients were rapidly treated with oxygen, diuretics, morphine, and nitrates. However, only a small increase in oxygen saturation was observed. Intravenous atenolol was administered and led to a dramatic increase in SpO₂. In our case series, we observed the positive effect of early treatment with short-acting beta-adrenergic antagonists on the recovery of rapid oxygen delivery in severely hypoxemic patients.

Key words: :

• pulmonary edema
• atenolol
• beta blockers
• hypoxemia
• respiratory failure
• prehospital