Published on November 28, 2013
PULMONARY EDEMA By, Reshmi Unni
DEFINITION Pulmonary edema is the abnormal accumulation of fluid in the interstitial spaces surrounding the alveoli with the advancement of fluid accumulation in the alveolar spaces.
TYPES Cardiogenic pulmonary edema Noncardiogenic pulmonary edema Neurogenic pulmonary edema
CAUSES CARDIOGENIC PULMONARY EDEMA NONCARDIOGENIC PULMONARY EDEMA NEUROGENIC PULMONARY EDEMA • Hypertension • Left ventricular failure • cardiomyopathy • • • • • • • Aspiration of gastric contents Drugs eg. Narcotics Sepsis Pneumonia Smoke inhalation Malignancies Pancreatitis • Head injury
PATHOPHYSIOLOGY Increase in the fluid filtration into the interstitial spaces of the lung Movement of the fluid from the interstitium in to the alveolar walls Damage of alveolar epithelium Accumulation of fluid in the alveoli
SIGNS AND SYPTOMS Dyspnea Tachycardia Orthopnea Hypertension Thin and frothy sputum On auscultation, Rhonchi Crackle sound Right ventricular failure with the manifestation of hepatomegaly, jugular vein distension and peripheral edema
DIAGNOSTIC FINDINGS Pulse oximetry <85% ABG: PaO2 = 30-50mm of Hg Chest X-ray shows areas of “white out” (fluid filled area)
MANAGEMENT Correction of hypoxemia O2 therapy Mechanical ventilation Reducing preload Upright position Diuretics Vasodilators Reducing after load Antihypertensive agents Supporting perfusion Ionotropic medications
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Eine seltene Form des Lungenödems ist das Postobstruktionslungenödem (engl. negative pressure pulmonary edema, NPPE).