Chapter 15: Acute Pulmonary Edema
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Life-threatening, acute development of alveolar lung edema due to one or more of the following:
- Elevation of hydrostatic pressure in the pulmonary capillaries (left heart failure, mitral valve disease).
- Specific precipitants (Table 15-1), resulting in cardiogenic pulmonary edema in pts with previously compensated heart failure or without previous cardiac history.
- Increased permeability of pulmonary alveolar-capillary membrane (noncardiogenic pulmonary edema). For common causes, see Table 15-2.
Acute tachy- or bradyarrhythmia |
Infection, fever |
Acute MI |
Severe hypertension |
Acute mitral or aortic regurgitation |
Increased circulating volume (Na+ ingestion, blood transfusion, pregnancy) |
Increased metabolic demands (exercise, hyperthyroidism) |
Pulmonary embolism |
Noncompliance (sudden discontinuation) of chronic heart failure medications |
Direct Injury to Lung | |
Chest trauma, pulmonary contusion | Pneumonia |
Aspiration | Oxygen toxicity |
Smoke inhalation | Pulmonary embolism, reperfusion |
Hematogenous Injury to Lung | |
Sepsis | Multiple transfusions |
Pancreatitis | IV drug use, e.g., heroin |
Nonthoracic trauma | Cardiopulmonary bypass |
Possible Lung Injury Plus Elevated Hydrostatic Pressures | |
High-altitude pulmonary edema | Reexpansion pulmonary edema |
Neurogenic pulmonary edema |
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Life-threatening, acute development of alveolar lung edema due to one or more of the following:
- Elevation of hydrostatic pressure in the pulmonary capillaries (left heart failure, mitral valve disease).
- Specific precipitants (Table 15-1), resulting in cardiogenic pulmonary edema in pts with previously compensated heart failure or without previous cardiac history.
- Increased permeability of pulmonary alveolar-capillary membrane (noncardiogenic pulmonary edema). For common causes, see Table 15-2.
Acute tachy- or bradyarrhythmia |
Infection, fever |
Acute MI |
Severe hypertension |
Acute mitral or aortic regurgitation |
Increased circulating volume (Na+ ingestion, blood transfusion, pregnancy) |
Increased metabolic demands (exercise, hyperthyroidism) |
Pulmonary embolism |
Noncompliance (sudden discontinuation) of chronic heart failure medications |
Direct Injury to Lung | |
Chest trauma, pulmonary contusion | Pneumonia |
Aspiration | Oxygen toxicity |
Smoke inhalation | Pulmonary embolism, reperfusion |
Hematogenous Injury to Lung | |
Sepsis | Multiple transfusions |
Pancreatitis | IV drug use, e.g., heroin |
Nonthoracic trauma | Cardiopulmonary bypass |
Possible Lung Injury Plus Elevated Hydrostatic Pressures | |
High-altitude pulmonary edema | Reexpansion pulmonary edema |
Neurogenic pulmonary edema |
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