Question?問題：

The mainstay of treatment of acute hypertensive cardiogenic pulmonary edema is high dose nitrates. Why is furosemide not recommended in the initial resuscitation of such patients??

急性高血壓心源性肺水腫的核心治療是高濃度硝酸鹽（硝普鈉，硝酸甘油）。為什么不建議在開始搶救這些患者時用速尿？

Answer?答案：

Furosemide causes activation of the renin-angiotensin-aldosterone neurohormonal pathway, acutely leading to increased plasma catecholamines, vasoconstriction, increased LV filling pressure and LV dysfunction.?

速尿會激活腎素-血管緊張素-醛固酮神經(jīng)內(nèi)分泌路徑，快速導(dǎo)致血漿兒茶酚胺升高，血管收縮，左心室充盈壓升高，和左心室衰竭。

參考文獻：

Am J EM, epub, 12/13/20