7th March 2024

A 32 year old female presents to the emergency department with acute onset shortness of breath, orthopnoea and peripheral oedema.

A 32 year old female presents to the emergency department with acute onset shortness of breath, orthopnoea and peripheral oedema. She is a gravida 5 para 3 at 32/40 gestation with a background history of hypertension and type 2 diabetes. A bedside echo in the ED department suggests significant LV impairment. Her current observations are thus: heart rate 95, BP 130/84, RR 24, SaO2 90% on 4L by nasal cannula.

ABG shows pH 7.34, PaO2 7.9, pCO2 5.5, lactate 2.2, HCO3 24.5

How would she be best treated acutely?

Select the SINGLE most appropriate option from the list below. Select ONE option only.