Table 1
Author, date,and countryPatient groupStudy type(level of evidence)OutcomesKey resultsStudy weaknesses
Tan LBet al, 1988,UK11 patients (9 male; 2 female) with severe heart failure (New York Heart Association grade 4). Patients had invasive haemodynamic monitoring. All patients were given 50 mg intravenous cyclizine, monitored for 30 min, then given 10 mg intravenous diamorphine. Parameters were measured at baseline, and 10 min and 30 min after administration of cyclizineObservational studyHeart rate (beats/min)99.9 at baseline; 107 at 10 min (p<0.05); 107 at 30 minSmall study in a very specific group of patients
Right atrial pressure(mm Hg)10.1 at baseline; 12.7 at 10 min (p<0.01); 13.1 at 30 min (p<0.01)
Mean pulmonary artery pressure(mm Hg)37.9 at baseline; 43.8 at 10 min (p<0.01); 43.1at 30 min (p<0.01)
Pulmonary artery wedge pressure(mm Hg)21.9 at baseline; 27.7 at 10 min (p<0.01); 27.0 at 30 min (p<0.01)
Mean blood pressure (mm Hg)82.5 at baseline; 91.5 at 10 min (p<0.01); 90.9 at 30 min (p<0.01)
Cardiac output (l/min)4.5 at baseline; 4.3 at 10 min; 4.1 at 30 min (p<0.01)
Systemic vascular resistance (dyne/cm2)1352 at baseline; 1576 at 10 min (p<0.05); 1608 at 30 min
Change in parameters after diamorphineAll returned to within 1 SEM 10 min after diamorphine administration (except for persistent elevation of right atrial and mean pulmonary pressures)