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Critical Care Medicine Aug 2015Neurogenic pulmonary edema is an underrecognized and underdiagnosed form of pulmonary compromise that complicates acute neurologic illness and is not explained by... (Review)
Review
OBJECTIVE
Neurogenic pulmonary edema is an underrecognized and underdiagnosed form of pulmonary compromise that complicates acute neurologic illness and is not explained by cardiovascular or pulmonary pathology. This review aims to provide a concise overview on pathophysiology, epidemiology, clinical characteristics, impact on outcome and treatment of neurogenic pulmonary edema, and considerations for organ donation.
DATA SOURCES
Database searches and a review of the relevant medical literature.
STUDY SELECTION
Selected studies included English-language articles concerning neurogenic pulmonary edema using the search terms "neurogenic" with "pulmonary oedema" or "pulmonary edema," "experimental neurogenic pulmonary edema," "donor brain death," and "donor lung injury."
DATA EXTRACTION
Selected studies were reviewed by both authors, and data extracted based on author consensus regarding relevance for this review.
DATA SYNTHESIS
Existing evidence is organized to address: 1) pathophysiology, 2) epidemiology and association with different neurologic diseases, 3) clinical presentation, 4) impact on outcome, 5) treatment, and 6) implications for organ donation after brain death.
CONCLUSIONS
Neurogenic pulmonary edema occurs as a complication of acute neurologic illness and may mimic acute lung injury of other etiology. Its presence is important to recognize in patients due to its impact on clinical course, prognosis, and treatment strategies.
Topics: Diagnosis, Differential; Fluid Therapy; Humans; Hypoxia; Nervous System Diseases; Prognosis; Pulmonary Edema; Respiration, Artificial
PubMed: 26066018
DOI: 10.1097/CCM.0000000000001101 -
Der Internist May 2004An acute respiratory insufficiency as a result of pulmonary oedema is regarded as a life threatening emergency event. Diagnostic classification differentiates between... (Review)
Review
An acute respiratory insufficiency as a result of pulmonary oedema is regarded as a life threatening emergency event. Diagnostic classification differentiates between cardiogenic and non-cardiogenic lung oedema. Symptomatic treatment of the impaired gas exchange often precedes a causal therapy of the underlying disease. For this purpose non-invasive ventilation, in parallel with efficient medical interventions, has come into focus. Moreover, this therapeutic intervention can prevent from the necessity of endotracheal intubation in the majority of cases. Rapid restoration of arterial oxygenation along with medical support of the cardiac function (i.e. by nitrates, diuretics, ACE-inhibitors, etc.) results in improved myocardial oxygen-delivery and reduced oxygen-consumption. This article reviews mainly the pathophysiology of cardiogenic lung edema, while most of the currently discussed therapeutic implications also apply to other entities of lung edema.
Topics: Critical Care; Heart Failure; Humans; Oxygen Inhalation Therapy; Patient Care Management; Pulmonary Edema; Respiratory Insufficiency; Risk Assessment; Triage
PubMed: 15052405
DOI: 10.1007/s00108-004-1175-x -
Ugeskrift For Laeger Dec 1991Neurogenic pulmonary oedema (NPE) is a recognized, serious, relatively uncommon, acute complication of cerebral insults of various types. Despite numerous animal... (Review)
Review
Neurogenic pulmonary oedema (NPE) is a recognized, serious, relatively uncommon, acute complication of cerebral insults of various types. Despite numerous animal experimental investigations and case reports, the pathological physiology is not yet elucidated. An acute cerebral insult with raised intracranial pressure is accompanied by violent activation of the sympathetic system and increase in the concentrations of circulating catecholamines. Probably, hydrostatic influences and altered capillary permeability both play roles in the pathogenesis. Acute increase in the total vascular surface in the lungs may also be contributory. Treatment includes intubation and positive pressure ventilation, diuretics, infusion of synthetic catecholamines, alpha-receptor blockades and reduction of raised intracranial pressure by hyperventilation and drainage of liquor. The optimal treatment of NPE is not yet established on account of insufficient knowledge of the pathological physiology.
Topics: Brain Injuries; Cerebral Hemorrhage; Humans; Pulmonary Edema; Time Factors
PubMed: 1776204
DOI: No ID Found -
Interactive Cardiovascular and Thoracic... Jul 2022
Topics: Humans; Pleural Effusion; Pneumothorax; Pulmonary Edema
PubMed: 35751602
DOI: 10.1093/icvts/ivac170 -
Intensive Care Medicine Apr 2022
Topics: Acute Disease; Continuous Positive Airway Pressure; Humans; Intensive Care Units; Pulmonary Edema
PubMed: 35178595
DOI: 10.1007/s00134-022-06639-8 -
Nursing Standard (Royal College of... Jun 2016This informative CPD article on acute pulmonary oedema has improved my knowledge of the condition.
This informative CPD article on acute pulmonary oedema has improved my knowledge of the condition.
Topics: Dyspnea; Humans; Nursing Assessment; Pulmonary Edema; United Kingdom
PubMed: 27275916
DOI: 10.7748/ns.30.40.61.s46 -
Nature Reviews. Cardiology Mar 2013Oedema is one of the fundamental features of heart failure, but the pathophysiology of oedema varies. Patients present along a spectrum ranging from acute pulmonary... (Review)
Review
Oedema is one of the fundamental features of heart failure, but the pathophysiology of oedema varies. Patients present along a spectrum ranging from acute pulmonary oedema to gross fluid retention and peripheral oedema (anasarca). In patients with pure pulmonary oedema, the problem is one of acute haemodynamic derangement; the patient does not have excess fluid, but pulmonary venous pressure rises such that the rate of fluid transudation into the interstitium of the lung exceeds the capacity of the pulmonary lymphatics to drain away the fluid. Conversely, in patients with peripheral oedema, the problem is one of fluid retention. Understanding the causes of oedema will enable straightforward, correct management of the condition. For patients with acute pulmonary oedema, vasodilatation is important to reduce cardiac filling pressures. For patients with fluid retention, removing the fluid, using either diuretics or mechanical means, is the most important consideration.
Topics: Aged; Capillary Permeability; Edema; Female; Heart Failure; Hemodynamics; Humans; Male; Prognosis; Pulmonary Edema; Risk Factors; Water-Electrolyte Balance
PubMed: 23319101
DOI: 10.1038/nrcardio.2012.191 -
Revue Medicale de Liege Apr 2004Acute cardiogenic pulmonary oedema frequently occurs in clinical practice, frequently in an old patient. It consists in acute respiratory distress related to rapid... (Review)
Review
Acute cardiogenic pulmonary oedema frequently occurs in clinical practice, frequently in an old patient. It consists in acute respiratory distress related to rapid development of transsudative fluid within the lung interstitium and alveolar accumulation. It requires rapid assessment and therapy to prevent progression to respiratory failure and cardiovascular collapse. The pathogenesis and identification of the underlying disease process are essential for optimal medical approach. The aetiology is multiple.
Topics: Acute Disease; Adult; Age Factors; Aged; Heart Diseases; Humans; Incidence; Middle Aged; Prognosis; Pulmonary Edema; Risk Factors
PubMed: 15182027
DOI: No ID Found -
Nursing Standard (Royal College of... Feb 2016Acute pulmonary oedema is a distressing and life-threatening illness that is associated with a sudden onset of symptoms. For the best possible patient outcomes, it is...
Acute pulmonary oedema is a distressing and life-threatening illness that is associated with a sudden onset of symptoms. For the best possible patient outcomes, it is essential that nurses in all clinical areas are equipped to accurately recognise, assess and manage patients with acute pulmonary oedema. This article outlines the pathophysiology of acute cardiogenic and non-cardiogenic pulmonary oedema, and suggests a systematic approach to the recognition and management of its most serious manifestations. Long-term care and symptom recognition are discussed and suggestions for ongoing patient self-management are provided.
Topics: Education, Nursing, Continuing; Humans; Nursing Assessment; Pulmonary Edema; United Kingdom
PubMed: 26838657
DOI: 10.7748/ns.30.23.51.s47 -
Ugeskrift For Laeger Jun 2021Swimming-induced pulmonary oedema (SIPE) is a rare condition, where hemodynamic changes associated with immersion in water and swimming induces pulmonary oedema. Here,...
Swimming-induced pulmonary oedema (SIPE) is a rare condition, where hemodynamic changes associated with immersion in water and swimming induces pulmonary oedema. Here, we report a case with a 57-year old very fit female triathlete experiencing critical lung edema during low intensity open water swimming. We speculate, that SIPE in this particular patient was caused by a combination of factors: 1) Stress-induced diastolic dysfunction, 2) tendency to vasoconstriction upon stress and 3) possibly paroxysmal atrial fibrillation induced by increased atrial pressure during the event.
Topics: Female; Hemodynamics; Humans; Middle Aged; Pulmonary Edema; Swimming; Water
PubMed: 34219637
DOI: No ID Found