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Pulmonary Edema

 


BASICS

DESCRIPTION

  • Pulmonary capillaries leak fluid into the lung interstitium and alveoli, leading to hypoxia and respiratory distress.

  • Fluid accumulation results from cardiogenic causes (e.g., heart f...

DIAGNOSIS

HISTORY

  • Past medical history

    • Underlying comorbidities, including prior heart failure or prior myocardial infarction (MI)

    • Recent trauma

    • Drug (illicit opiate, cocaine) or alcohol abuse

    • Dietary or m...

TREATMENT

GENERAL MEASURES

  • The mainstay of therapy, in all cases, is to address the suspected cause/condition.

  • Ensure adequate reversal of hypoxia.

MEDICATION

Cardiogenic pulmonary edema 

First Line

  • Diureti...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Strict input/output measurement, daily weights

  • Posthospitalization appointment in 7 to 10 days

DIET

Low-sodium diet (<2 g/day), fluid restrictio...

ADDITIONAL READING

Putensen C, Theuerkauf N, Zinserling J, et al. Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury. Ann Intern Med. ...

SEE ALSO

  • Altitude Illness; Respiratory Distress Syndrome, Acute (ARDS)

  • Algorithm: Congestive Heart Failure: Differential Diagnosis

CODES

ICD10

  • J81.1 Chronic pulmonary edema

  • J81.0 Acute pulmonary edema

ICD9

  • 514 Pulmonary congestion and hypostasis

  • 518.4 Acute edema of lung, unspecified

SNOMED

  • 19242006 pulmonary edema (disorder)

  • 46847001 Ch...

CLINICAL PEARLS

  • Diagnosis of the underlying etiology is essential.

  • Initial treatment of acute cardiogenic edema among hypertensive/normotensive patients includes IV diuretics, IV nitrates, and NPPV.

  • Hyp...

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