pulmonary edema

موضوع: pulmonary edema الإثنين ديسمبر 07, 2009 10:12 pm

Pulmonary Edema

Pulmonary Edema is extravasation of fluid from the pulmonary vasculature into the interstitium and alveoli
of the lung

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The formation of pulmonary edema may be caused by 4 major pathophysiologic mechanisms:

(1) imbalance of Starling forces (ie, increased pulmonary capillary pressure, decreased plasma oncotic pressure, increased negative interstitial pressure),

(2) damage to the alveolar-capillary barrier,

(3) lymphatic obstruction

(4) idiopathic or unknown mechanism.
and it can be result of inadequate functioning of the heart or circulatory system.

When directly or indirectly caused by increased pulmonary blood pressure, pulmonary edema may appear when this pressure increases from the normal 15 mmHg[3] to above 25 mmHg

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Symptoms of Pulmonary edema
Anxiety
Cough
Difficulty breathing
Excessive sweating
Feeling of "air hunger" or "drowning" (if this occurs suddenly, awakening you from sleep and causing you to sit up and catch your breath, it's called "paroxysmal noctural dyspnea")
Grunting or gurgling sounds with breathing
Pale skin
Restlessness
Shortness of breath
Shortness of breath when lying down (orthopnea) -- you may need to sleep with your head propped up or use extra pillows
Wheezing
Additional symptoms that may be associated with this disease:

Coughing up blood or bloody froth
Decrease in level of awareness
Inability to speak in full sentences
Nasal flaring

Exams and Tests

The health care provider will perform a physical exam and use a stethoscope to listen to the lungs and heart. The following may be detected
:

* Crackles in the lungs, called rales
* Abnormal heart sounds
* Increased heart rate (tachycardia)
* Pale or blue skin color (pallor or cyanosis)
* Rapid breathing (tachypnea)

Possible tests include:

The health care provider will perform a physical exam and use a stethoscope to listen to the lungs and heart. You may have:

Crackles in the lungs or abnormal heart sounds
Increased heart rate
Pale or blue skin color
Rapid breathing
Possible tests include:

Blood oxygen levels -- low in patients with pulmonary edema
Chest x-ray -- may reveal fluid in or around the lung space or an enlarged heart
Electrocardiogram (ECG) -- to detect abnormal heart rhythm or evidence of a heart attack
Ultrasound of the heart (echocardiogram) -- to see if there is a weak heart muscle, leaky or narrow heart valves, or fluid surrounding the heart

What is the treatment for pulmonary edema?

The treatment of pulmonary edema largely depends on its cause and severity.

Most cases of cardiac pulmonary edema are treated by using diuretics (water pills) along with other medications for heart failure. In the majority of situations, appropriate treatment can be achieved as an outpatient by taking oral medications. If the pulmonary edema is more severe or it is not responsive to oral medications, then hospitalization and the use of intravenous diuretic medications may be necessary.

The treatment for noncardiac causes of pulmonary edema varies depending on the cause. For example, severe infection (sepsis) needs to treated with antibiotics and other supportive measures, or kidney failure needs to be properly evaluated and managed.

Oxygen supplementation is sometimes necessary if the measured oxygen level in the blood is too low. In serious conditions, such as ARDS, placing a patient on an artificial breathing machine is necessary to support their breathing while other measures are taken to treat
pulmonary edema and its underlying cause.

Prevention

If you have a disease that can lead to pulmonary edema, you should be sure to take all medicines as instructed. Following a healthy diet, one usually low in salt, can significantly decrease your risk of this condition.

موضوع: رد: pulmonary edema السبت ديسمبر 12, 2009 3:05 pm

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موضوع: رد: pulmonary edema السبت ديسمبر 12, 2009 7:19 pm

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