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Review
. 2020 Jul 28:6:e20.
doi: 10.15420/cfr.2019.22. eCollection 2020 Mar.

Morphine in the Setting of Acute Heart Failure: Do the Risks Outweigh the Benefits?

Oren Caspi  1 , Doron Aronson  1
Affiliations
Review

Morphine in the Setting of Acute Heart Failure: Do the Risks Outweigh the Benefits?

Oren Caspi et al. Card Fail Rev. .

Abstract

The use of opioids in acute pulmonary oedema is considered standard therapy by many physicians. The immediate relieving effect of morphine on the key symptomatic discomfort associated with acute heart failure, dyspnoea, facilitated the categorisation of morphine as a beneficial treatment in this setting. During the last decade, several retrospective studies raised concerns regarding the safety and efficacy of morphine in the setting of acute heart failure. In this article, the physiological effects of morphine on the cardiovascular and respiratory systems are summarised, as well as the potential clinical benefits and risks associated with morphine therapy. Finally, the reported clinical outcomes and adverse event profiles from recent observational studies are discussed, as well as future perspectives and potential alternatives to morphine in the setting of acute heart failure.

Keywords: Acute heart failure; congestion; mechanical ventilation; morphine; opiates.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. ORs and 95% CIs for Invasive Ventilation and In-hospital Mortality According to Morphine Dose
See this image and copyright information in PMC

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