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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
Pulmonary edema

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Pulmonary edema