1.3.3 Offer intravenous diuretic therapy to people with acute heart failure. Start treatment using either a bolus or infusion strategy. 1.3.4 For people already taking a diuretic, consider a higher dose of diuretic than that on which the person was admitted unless there are serious concerns with patient adherence to diuretic therapy before admission. 1.3.5 Closely monitor the person's renal function, weight and urine output during diuretic therapy. 1.3.6 Discuss with the person the best strategies of coping with an increased urine output. 1.3.7 Do not routinely offer nitrates to people with acute heart failure. 1.3.8 If intravenous nitrates are used in specific circumstances, such as for people with concomitant myocardial ischaemia, severe hypertension or regurgitant aortic or mitral valve disease, monitor blood pressure closely in a setting where at least level 2 care can be provided. 1.3.9 Do not offer sodium nitroprusside to people with acute heart failure. 1.3.10 Do not routinely offer inotropes or vasopressors to people with acute heart failure. 1.3.11 Consider inotropes or vasopressors in people with acute heart failure with potentially reversible cardiogenic shock. Administer these treatments in a cardiac care unit or high dependency unit or an alternative setting where at least level 2 care can be provided. Level 2 care is for people needing more detailed observation or intervention, including support for a single failing organ system or postoperative care and for those stepping down from higher levels of care. From levels of critical care for adult patients. 1.4 Initial non-pharmacological treatment 1.4.1 Do not routinely use non-invasive ventilation (continuous positive airways pressure [CPAP] or non-invasive positive pressure ventilation [NIPPV]) in people with acute heart failure and cardiogenic pulmonary oedema. 