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    Pulmonary Edema

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    Mohmmad Lateef Ganie
    Pulmonary edema is fluid accumulation in the lungs that can be caused by cardiogenic (cardiac-related) or non-cardiogenic factors. Cardiogenic pulmonary edema is due to increased pressure in the pulmonary capillaries from cardiac abnormalities leading to high venous pressure, causing fluid to accumulate in the lungs. Symptoms include shortness of breath, cough, and chest pain. Diagnosis involves chest x-ray and echocardiogram. Treatment focuses on addressing the underlying heart or lung cause and providing respiratory support.

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    Download as PPTX, PDF, TXT or read online from Scribd

    Pulmonary Edema

    Uploaded by

    Mohmmad Lateef Ganie
    141 views20 pages
    Pulmonary edema is fluid accumulation in the lungs that can be caused by cardiogenic (cardiac-related) or non-cardiogenic factors. Cardiogenic pulmonary edema is due to increased pressure in the pulmonary capillaries from cardiac abnormalities leading to high venous pressure, causing fluid to accumulate in the lungs. Symptoms include shortness of breath, cough, and chest pain. Diagnosis involves chest x-ray and echocardiogram. Treatment focuses on addressing the underlying heart or lung cause and providing respiratory support.

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    Pulmonary edema

    Original Title

    Pulmonary edema

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    Pulmonary edema is fluid accumulation in the lungs that can be caused by cardiogenic (cardiac-related) or non-cardiogenic factors. Cardiogenic pulmonary edema is due to increased pressure in the pulmonary capillaries from cardiac abnormalities leading to high venous pressure, causing fluid to accumulate in the lungs. Symptoms include shortness of breath, cough, and chest pain. Diagnosis involves chest x-ray and echocardiogram. Treatment focuses on addressing the underlying heart or lung cause and providing respiratory support.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    141 views20 pages

    Pulmonary Edema

    Uploaded by

    Mohmmad Lateef Ganie
    Pulmonary edema is fluid accumulation in the lungs that can be caused by cardiogenic (cardiac-related) or non-cardiogenic factors. Cardiogenic pulmonary edema is due to increased pressure in the pulmonary capillaries from cardiac abnormalities leading to high venous pressure, causing fluid to accumulate in the lungs. Symptoms include shortness of breath, cough, and chest pain. Diagnosis involves chest x-ray and echocardiogram. Treatment focuses on addressing the underlying heart or lung cause and providing respiratory support.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 20

    Pulmonary Edema

    Definition
    is a condition
    Pulmonary Edema ;
    characterized by fluid accumulation in
    the lungs caused by extravasation of
    fluid from pulmonary vasculature in to
    the interstitium and alveoli of the lungs
    Epidemiology
     Pulmonary edema occurs in about 1% to 2% of the general
    population.

     Between the ages of 40 and 75 years, males are affected


    more than females.

     After the age of 75 years, males and females are affected


    equally.

     The incidence of pulmonary edema increases with age and


    may affect about 10% of the population over the age of 75
    years.
    Classification
    Base on underlining cause

    o Cardiogenic pulmonary edema


    o Non-cardiogenic pulmonary edema
    Cardiogenic pulmonary
    edema
    Is Pulmonary edema due to
    increased pressure in the pulmonary
    capillaries because of cardiac
    abnormalities that lead to an
    increase in pulmonary venous
    pressure.
    o Hydrostatic pressure is increased
    and fluid exit capillary at increased
    rate
    Cardiogenic PE

     Basic pathophysiology:

    A rise in pulmonary venous and


    pulmonary capillary pressures pushes
    fluid into the pulmonary alveoli and
    interstitium.
    CXR: B/L perihilar bat’s wing
    appearance,symmetric opacification
    of lung fields
    Pathogenesis of CPE
    Left sided heart failure

    Decrease pumping ability to the systemic circulation

    Congestion & accumulation of blood in the pulmonary area

    Fluid leaks out of the intravascular space to the interstitium

    Accumulation of fluid
    `

    Pulmonary edema
    Risk Factors

     Vary by cause

    Leading risk factor is clearly


    -

    underlying cardiac disease.


    Causes of Cardiogenic PE

     LV failure is the most common


    cause.
     Dysrhythmia
     LV hypertrophy and
    cardiomyopathy
     LV volume over load
     Myocardia infarction
     left ventricular outflow
    obstruction
    Non cardiogenic
    pulmonary edema
    It is defined as the evidence of alveolar
    fluid accumulation with out
    hemodynamic evidence that suggest a
    cardiogenic etiology.
    Hydrostatic pressure is normal
    Leakage of protein and other molecule
    in to the tissue
    Non- cardiogenic PE

     cause
    I. Direct injury to the lung
    II. Hematogenous injury to the
    lung
    III. possible lung injury plus
    elevated hydrostatic pressure
    Symptom of pulmonary
    edema
    ACUTE
     Shortness of breath
     A Feeling of suffocating
     Anxiety ,restlessness
     Cough-frothy sputum that may be tinged with
    blood
     excessive sweating
     pale skin
     chest pain if PE is cause by cardiac abnormality
     palpitation
    Symptom……

    Long term(chronic)
     Paraxosomal nocturnal dyspnea
     orthopnea
     Rapid weight gain
     Loss of appetite
     fatigue
     ankle and leg swelling
    Signs

     Tachycardia
     Tachypnea
     Confusion
     Agitation
     Anxious
     Diaphoric
     Hypertension
     Cool extremities
     Rales
     Wheezing
     CVS findings ; S3 ,accentuation of pulmonic
    component of S2, jugular venous distention…..
    Complications

     leg swelling(edema),
     abdominal swelling(ascites),
     Pleural effusion,
     Congestion & swelling of liver,
     acute heart attack (myocardial infarction [MI]),
     cardiogenic shock,
     arrhythmias,
     electrolyte disturbances,
    INVESTIGATIONS

     CXR-PA view:
    unilateral or bilateral involvement,cardiogenic
    pattern or non cardiognic pattern(air bronchogram
    signs, fluffy opacities, asymmetrical inhomogenous
    involvement),lobar involvement in post infectious PE.
     ABG analysis:
    hypoxia and hypocapnia initially with respi. alkalois
    hypercapnea in later stage with respi and
    metabolic acidosis
     Hemodynamic measurement with Swan-Ganz
    catheter
     Blood work up and septic screen
    Management stretagy

     Treat underlying cause : Sepsis,heart failure,high


    altitude hypoxia,obstruction,fluid
    overload,hypoproteinemia etc.
     Respi support: NIV vs Intubation f/b venti support
    Management stretagy…

     Principles of mechanical ventilation


    Two fundamental principles
    1. Prevention of overdistension of alveoli-limiting
    tidal volume or inspiratory pressure
    2. Choose the level of PEEP sufficiently high to
    prevent derecruitment of alveoli at end of
    expiration
    1. Limiting tidal volume
    High TV 12-15 ml per kg are
    dangerous in patient with PE
    Can lead to VOLUTRAUMA
    Tidal volume kept at 6-8 ml per kg
    to start with in patient of PE
    Then adjusted to keep the plateau
    pressure below 30 cm of H2O
    THANK YOU

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