Pulmonary edema

Pulmonary edema (AL). Life-threatening bleeding of the alveoli in the cavity of a protein-rich, easily expandable serous fluid.

OL heart see. Cardiac asthma and pulmonary edema.

OL noncardiac. Etiology and Pathogenesis: loss of lung tissue - infectious (see Pneumonia.), Allergic, toxic, traumatic; pulmonary embolism (cm.); pulmonary infarction (cm.); Goodpasture's syndrome (cm.); 2) violation of water-zlektrolitnogo balance, hypervolemia (infusion therapy, renal failure, endocrine pathology and steroid therapy, pregnancy); 3) drowning in salt water; 4) violation of the central regulation - stroke, subarachnoid hemorrhage, brain damage (toxic, infectious, traumatic), with overexcitation vagal center; 5) reduction in intrathoracic pressure -with rapid evacuation of liquid from the abdominal cavity, fluid or air from the pleural cavity, rise to great heights, forced inspiration; 6) the excess therapy (infusion, medication, oxygen therapy) in shock, burns, infections, poisoning and other serious conditions, including after serious operations ( "shock lung"); 7) various combinations of these factors, such as pneumonia in high altitude conditions (need urgent evacuation of the patient!).

Filling of the alveolar fluid and foam leads to asphyxia (cm.): The patient "drowning" in its own serous fluid. In the conditions of hypoxia and acidosis permeability of the alveolar-capillary membrane is increased exudation of serous fluid increases (vicious circle), the effectiveness of drug treatment falls (see. As cardiac asthma and pulmonary edema).

Symptoms During cm. Cardiac asthma and pulmonary edema, as well as the listed diseases and conditions, a complication which was the AL.

Treatment of an emergency (danger to life, the threat of further closures vicious circles), differentiated, determined by the specific etiology, pathogenesis and clinical manifestations of herpes zoster. In many cases, especially when toxic, allergic and infectious origin OL with the defeat of the alveolar-capillary membrane, as well as hypotension successfully used high doses of corticosteroids. Prednisolone hemisuccinate (bisuktsinat) repeatedly for Mr. 0,025-0,15 3-6 ampoules (up to 1200-1500 mg / day) or hydrocortisone hemisuccinate - 0,125-300 mg (up to 1200 to 1500 mg / day) was administered in a drip into a vein isotonic sodium chloride solution, glucose solution or other infusion. Nitroglycerin, powerful diuretics, aminophylline not shown when hypovolemia, hypotension. Narcotic analgesics are contraindicated in brain edema and, as a rule, with primary pulmonary origin OL. Oxygen therapy may be contraindicated in severe respiratory failure, oligopnoe. In light of shock fluid resuscitation, correction of acid-base balance and oxygen therapy should be performed with caution, under close supervision, usually in a hospital. With these caveats, the treatment is carried out in relation to the scheme shown below in cardiac asthma and pulmonary edema (see.).