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Pulmonary edema

Not to be confused with Pneumonia.

Pulmonary edema
Other namesPulmonary oedema
Pulmonary edema with small pleural effusions on both sides
SpecialtyCardiology, critical care medicine pulmonology
SymptomsProgressive dyspnea, cough, fever, cyanosis, tachycardia
ComplicationsARDS, respiratory failure
CausesCardiogenic, Noncardiogenic (pneumonia, inhalation injury, sepsis, airway obstruction, high altitude)
Diagnostic methodMedical imaging, lab tests, ECG, echocardiography
TreatmentSupplemental oxygen, diuretics, treat underlying disease process

Pulmonary edema (British English: oedema), also known as pulmonary congestion, is excessive fluid accumulation in the tissue or air spaces (usually alveoli) of the lungs.[1] This leads to impaired gas exchange, most often leading to shortness of breath (dyspnea) which can progress to hypoxemia and respiratory failure. Pulmonary edema has multiple causes and is traditionally classified as cardiogenic (caused by the heart) or noncardiogenic (all other types not caused by the heart).[2][3]

Various laboratory tests (CBC, troponin, BNP, etc.) and imaging studies (chest x-ray, CT scan, ultrasound) are often used to diagnose and classify the cause of pulmonary edema.[4][5][6]

Treatment is focused on three aspects:

  • improving respiratory function,
  • treating the underlying cause, and
  • preventing further damage and allow full recovery to the lung.

Pulmonary edema can cause permanent organ damage, and when sudden (acute), can lead to respiratory failure or cardiac arrest due to hypoxia.[7] The term edema is from the Greek οἴδημα (oidēma, "swelling"), from οἰδέω (oidéō, "(I) swell").[8][9]

  1. ^ Dorland's illustrated medical dictionary (32nd ed.). Saunders/Elsevier. 2 May 2011. p. 593. ISBN 978-1-4160-6257-8.
  2. ^ Assaad S, Kratzert WB, Shelley B, Friedman MB, Perrino A (April 2018). "Assessment of Pulmonary Edema: Principles and Practice" (PDF). Journal of Cardiothoracic and Vascular Anesthesia. 32 (2): 901–914. doi:10.1053/j.jvca.2017.08.028. PMID 29174750.
  3. ^ Ware LB, Matthay MA (December 2005). "Clinical practice. Acute pulmonary edema". The New England Journal of Medicine. 353 (26): 2788–2796. doi:10.1056/NEJMcp052699. PMID 16382065.
  4. ^ Lindow T, Quadrelli S, Ugander M (November 2023). "Noninvasive Imaging Methods for Quantification of Pulmonary Edema and Congestion: A Systematic Review". JACC. Cardiovascular Imaging. 16 (11): 1469–1484. doi:10.1016/j.jcmg.2023.06.023. PMID 37632500.
  5. ^ Guo L, Yang X, Yang B, Tang G, Li C (July 2023). "Prevalence, in-hospital mortality, and factors related to neurogenic pulmonary edema after spontaneous subarachnoid hemorrhage: a systematic review and meta-analysis". Neurosurgical Review. 46 (1): 169. doi:10.1007/s10143-023-02081-6. PMC 10335949. PMID 37432487.
  6. ^ Komiya K, Akaba T, Kozaki Y, Kadota JI, Rubin BK (August 2017). "A systematic review of diagnostic methods to differentiate acute lung injury/acute respiratory distress syndrome from cardiogenic pulmonary edema". Critical Care. 21 (1): 228. doi:10.1186/s13054-017-1809-8. PMC 6389074. PMID 28841896.
  7. ^ Siddiqi TJ, Usman MS, Rashid AM, Javaid SS, Ahmed A, Clark D, et al. (July 2023). "Clinical Outcomes in Hypertensive Emergency: A Systematic Review and Meta-Analysis". Journal of the American Heart Association. 12 (14): e029355. doi:10.1161/JAHA.122.029355. PMC 10382109. PMID 37421281.
  8. ^ οἴδημα, οἰδέω. Liddell, Henry George; Scott, Robert; A Greek–English Lexicon at the Perseus Project.
  9. ^ Harper D. "edema". Online Etymology Dictionary.

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