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Michael A Matthay - One of the best experts on this subject based on the ideXlab platform.
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Acute Pulmonary Edema
2020Co-Authors: M.d Lorraine B Ware, Michael A MatthayAbstract:clinical practice T h e ne w e ngl a nd jou r na l o f m e dic i ne A 62-year-old man presents with a three-day history of progressive dyspnea, nonproductive cough, and low-grade fever. He had been hospitalized two years earlier for congestive heart failure. His blood pressure is 95/55 mm Hg, his heart rate 110 beats per minute, his temperature 37.9°C, and his oxygen saturation while breathing ambient air 86 percent. Chest auscultation reveals rales and rhonchi bilaterally. A chest radiograph shows bilateral Pulmonary infiltrates consistent with Pulmonary Edema and borderline enlargement of the cardiac silhouette. How should this patient be evaluated to establish the cause of the acute Pulmonary Edema and to determine appropriate therapy? the clinical problem The following two fundamentally different types of Pulmonary Edema occur in humans: cardiogenic Pulmonary Edema (also termed hydrostatic or hemodynamic Edema) and noncardiogenic Pulmonary Edema (also known as increased-permeability Pulmonary Edema, acute lung injury, or acute respiratory distress syndrome). Although they have distinct causes, cardiogenic and noncardiogenic Pulmonary Edema may be difficult to distinguish because of their similar clinical manifestations. Knowledge of the cause of acute Pulmonary Edema has important implications for treatment. Patients with cardiogenic Pulmonary Edema typically are treated with diuretics and afterload reduction, although the underlying cause may require other treatment, including coronary revascularization. 1 Patients with noncardiogenic Pulmonary Edema who require mechanical ventilation should be ventilated with a low tidal volume (6 ml per kilogram of predicted body weight) and a plateau airway pressure less than 30 cm of water. This lung-protective strategy of ventilation reduces mortality in patients with acute lung injury. 2,3 In addition, for patients with severe sepsis, recombinant activated protein C 4 and low-dose hydrocortisone 5 should be considered. Prompt diagnosis of the cause of acute Pulmonary Edema with the use of noninvasive methods, supplemented by catheterization of the Pulmonary artery when there is diagnostic uncertainty, facilitates timely and appropriate treatment. Accurate diagnosis of acute Pulmonary Edema requires an understanding of microvascular fluid exchange in the lun
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negative pressure Pulmonary Edema
Chest, 2016Co-Authors: Mallar Bhattacharya, Richard H Kallet, Lorraine B Ware, Michael A MatthayAbstract:Negative-pressure Pulmonary Edema (NPPE) or postobstructive Pulmonary Edema is a well-described cause of acute respiratory failure that occurs after intense inspiratory effort against an obstructed airway, usually from upper airway infection, tumor, or laryngospasm. Patients with NPPE generate very negative airway pressures, which augment transvascular fluid filtration and precipitate interstitial and alveolar Edema. Pulmonary Edema fluid collected from most patients with NPPE has a low protein concentration, suggesting hydrostatic forces as the primary mechanism for the pathogenesis of NPPE. Supportive care should be directed at relieving the upper airway obstruction by endotracheal intubation or cricothyroidotomy, institution of lung-protective positive-pressure ventilation, and diuresis unless the patient is in shock. Resolution of the Pulmonary Edema is usually rapid, in part because alveolar fluid clearance mechanisms are intact. In this review, we discuss the clinical presentation, pathophysiology, and management of negative-pressure or postobstructive Pulmonary Edema.
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clinical practice acute Pulmonary Edema
The New England Journal of Medicine, 2005Co-Authors: Lorraine B Ware, Michael A MatthayAbstract:A 62-year-old man presents with a three-day history of progressive dyspnea, nonproductive cough, and low-grade fever. His blood pressure is 100/60 mm Hg, his heart rate 110 beats per minute, his temperature 37.9°C, and his oxygen saturation while breathing room air 86 percent. Chest auscultation reveals rales and rhonchi bilaterally. A chest radiograph shows bilateral Pulmonary infiltrates consistent with Pulmonary Edema and borderline enlargement of the cardiac silhouette. How should this patient be evaluated to establish the cause of the acute Pulmonary Edema and to determine appropriate therapy?
Terzi R.g.g. - One of the best experts on this subject based on the ideXlab platform.
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Neurogenic Pulmonary Edema: Report Of Two Cases [Edema Pulmonar Neurogênico: Relato De Dois Casos]
2015Co-Authors: Dragosavac D, Araújo S, Falcao A.l.e., Terzi R.g.g.Abstract:Neurogenic Pulmonary Edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic Pulmonary Edema, one with head injury and other with intracerebral hemorrhage Diagnosis was made by rapid onset of Pulmonary Edema, severe hypoxemia, decrease of Pulmonary complacence and diffuse Pulmonary infiltrations, without previous history of tracheal aspiration or any other risk factor for developement of adult respiratory distress syndrom In the first case, with severe head trauma, neurogenic Pulmonary Edema was diagnosed at admission one hour after trauma, associated with severe systemic inflammatory reaction. and good outcome in three days. The second case, with hemorragic vascular insult, developed neurogenic Pulmonary Edema the fourth day after drenage of intracerebral hematom and died.552305309Bembridge, M., Madej, T.H., Neurogenic Pulmonary oEdema (1985) Anaesthesia, 40, pp. 202-204Braude, N., Ludgrove, T., Neurogenic Pulmonary oEdema precipitated by induction of anaesthesia (1989) Br J Anaesth, 62, pp. 101-103Brito, J.C.F., Diniz, M.C.A., Rosas, R.R., Silva, J.A.G., Edema pulmonar agudo neurogênico relato de caso (1995) Arq Neuropsiquiatr, 53, pp. 288-293Brown, R.H., Beyerl, B.D., Iseke, R., Lavy, M.H., Medulla oblongata oEdema associated with neurogenic Pulmonary oEdema: Case report (1986) J Neurosurg, 64, pp. 494-500Casey, W.F., Neurogenic Pulmonary oEdema (1983) Anaesthesia, 38, pp. 985-988Dettbarn, C.L., Davidson, L.J., Pulmonary complications in the patient with acute head injury: Neurogenic Pulmonary oEdema (1989) Heart Lung, 18, pp. 583-589Ell, S.R., Neurogenic Pulmonary oEdema, a review of the literature and a perspective (1991) Inv Radiol, 26, pp. 499-506Falcão, A.L.E., Dantas, V.F., Sardinha, L.C., Quagliato, E.A.B., Diagosavac, D., Araújo, S., Terzi, R.G.G., Highlighting intracranial pressure monitoring in patients with severe acute brain trauma (1995) Arq Neuropsiquiatr, 53, pp. 390-394Falcão, A.L.E., Dantas, V.F., Saraiva, J.F.K., Sardinha, L.C., Araújo, S., Terzi, R.G.G., Bedside ICP monitoring in head trauma patients by using a simple. safe and low cost metodology (1992) Clin Int Care, 3 (SUPPL.), p. 112Graf, C.J., Rossi, N.P., Pulmonary oEdema and central nervous system.A clinico-pathological study (1975) Surg Neurol, 4, pp. 319-325Kauffman, H.H., Timberlake, G., Voelker, J., Glenn, P.T., Medical complications of head injury (1993) Med Clin North Am Jan, 70, pp. 43-60Knudsen, F., Jensen, H.P., Peterson, P.L., Neurogenic Pulmonary Edema treatment with dobutamine (1991) Neurosurgery, 29, pp. 269-270Li, C., Gefter, W.B., Acute Pulmonary Edema induced by overdosage of phenothiazines (1992) Chest, 101, pp. 102-104Malik, A.B., Mechanisms of neurogenic Pulmonary Edema (1985) Circ Res, 57, pp. 1-18Melone, E., Bonnet, F., Lepreslo, E., Fevrier, M.J., Djindjian, M., Francois, Y., Gray, F., Debras, C., Altered capillary permeability in neurogenic Pulmonary Edema (1985) Int Care Med, 11, pp. 323-325Murphy, P.G., Jackson, R., Kirollos, R., Gibson, J.S., Chennells, P., Adult respiratory distress syndrome after attenuated strangulation (1993) Br J Anasth, 70, pp. 583-586Pender, E.S., Pollack, C.V., Neurogenic Pulmonary Edema: Case reports and review (1992) J Em Med, 10, pp. 45-51Pollack, V., Pollack, E.S., Neurogenic Pulmonary Edema (1993) J Emerg Med, 11, pp. 207-210Simmons, R.L., Martin, A.M., Heisterkamp, C.A., Ducher, T.B., Respiratory insufficiency in combat casualties. II Pulmonary Edema following head injury (1969) Ann Surg, 170, pp. 39-41Simon, R.P., Neurogenic Pulmonary Edema (1993) Neurol Clin, 11, pp. 309-323Simon, R.P., Medullary lesion inducing Pulmonary Edema a magnetic resonance imaging study (1991) Ann Neurol, 30, pp. 727-730Toucho, H., Kavasawa, J., Sishido, H., Yamada, K., Yamazaki, Y., Neurogenic Pulmonary Edema in the acute stage of hemorrhagic cerebrovascular disease (1989) Neurosurgery, 25, pp. 762-768Wauchob, T.D., Brooks, R.J., Harrison, K.M., Neurogenic Pulmonary oEdema (1984) Anaesthesia, 39, pp. 529-534Wright, R.S., Feuerman, T., Brown, J., Neurogenic Pulmonary Edema after trigeminal nerve blockade (1989) Chest, 96, pp. 436-43
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Neurogenic Pulmonary Edema: Report Of Two Cases [Edema Pulmonar Neurogênico: Relato De Dois Casos]
2015Co-Authors: Dragosavac D, Araújo S, Falcao A.l.e., Terzi R.g.g.Abstract:Neurogenic Pulmonary Edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic Pulmonary Edema, one with head injury and other with intracerebral hemorrhage Diagnosis was made by rapid onset of Pulmonary Edema, severe hypoxemia, decrease of Pulmonary complacence and diffuse Pulmonary infiltrations, without previous history of tracheal aspiration or any other risk factor for developement of adult respiratory distress syndrom In the first case, with severe head trauma, neurogenic Pulmonary Edema was diagnosed at admission one hour after trauma, associated with severe systemic inflammatory reaction. and good outcome in three days. The second case, with hemorragic vascular insult, developed neurogenic Pulmonary Edema the fourth day after drenage of intracerebral hematom and died
Dragosavac D - One of the best experts on this subject based on the ideXlab platform.
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[neurogenic Pulmonary Edema. Report Of 2 Cases].
2015Co-Authors: Dragosavac D, Falcão A L, Araújo S, Terzi R GAbstract:Neurogenic Pulmonary Edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures. Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic Pulmonary Edema, one with head injury and other with intracerebral hemorrhage. Diagnosis was made by rapid onset of Pulmonary Edema, severe hypoxemia, decrease of Pulmonary complacence and diffuse Pulmonary infiltrations, without previous history of tracheal aspiration or any other risk factor for development of adult respiratory distress syndrome. In the first case, with severe head trauma, neurogenic Pulmonary Edema was diagnosed at admission one hour after trauma, associated with severe systemic inflammatory reaction, and good outcome in three days. The second case, with hemorrhagic vascular insult, developed neurogenic Pulmonary Edema the fourth day after drainage of intracerebral hematoma and died.55305-
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Neurogenic Pulmonary Edema: Report Of Two Cases [Edema Pulmonar Neurogênico: Relato De Dois Casos]
2015Co-Authors: Dragosavac D, Araújo S, Falcao A.l.e., Terzi R.g.g.Abstract:Neurogenic Pulmonary Edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic Pulmonary Edema, one with head injury and other with intracerebral hemorrhage Diagnosis was made by rapid onset of Pulmonary Edema, severe hypoxemia, decrease of Pulmonary complacence and diffuse Pulmonary infiltrations, without previous history of tracheal aspiration or any other risk factor for developement of adult respiratory distress syndrom In the first case, with severe head trauma, neurogenic Pulmonary Edema was diagnosed at admission one hour after trauma, associated with severe systemic inflammatory reaction. and good outcome in three days. The second case, with hemorragic vascular insult, developed neurogenic Pulmonary Edema the fourth day after drenage of intracerebral hematom and died.552305309Bembridge, M., Madej, T.H., Neurogenic Pulmonary oEdema (1985) Anaesthesia, 40, pp. 202-204Braude, N., Ludgrove, T., Neurogenic Pulmonary oEdema precipitated by induction of anaesthesia (1989) Br J Anaesth, 62, pp. 101-103Brito, J.C.F., Diniz, M.C.A., Rosas, R.R., Silva, J.A.G., Edema pulmonar agudo neurogênico relato de caso (1995) Arq Neuropsiquiatr, 53, pp. 288-293Brown, R.H., Beyerl, B.D., Iseke, R., Lavy, M.H., Medulla oblongata oEdema associated with neurogenic Pulmonary oEdema: Case report (1986) J Neurosurg, 64, pp. 494-500Casey, W.F., Neurogenic Pulmonary oEdema (1983) Anaesthesia, 38, pp. 985-988Dettbarn, C.L., Davidson, L.J., Pulmonary complications in the patient with acute head injury: Neurogenic Pulmonary oEdema (1989) Heart Lung, 18, pp. 583-589Ell, S.R., Neurogenic Pulmonary oEdema, a review of the literature and a perspective (1991) Inv Radiol, 26, pp. 499-506Falcão, A.L.E., Dantas, V.F., Sardinha, L.C., Quagliato, E.A.B., Diagosavac, D., Araújo, S., Terzi, R.G.G., Highlighting intracranial pressure monitoring in patients with severe acute brain trauma (1995) Arq Neuropsiquiatr, 53, pp. 390-394Falcão, A.L.E., Dantas, V.F., Saraiva, J.F.K., Sardinha, L.C., Araújo, S., Terzi, R.G.G., Bedside ICP monitoring in head trauma patients by using a simple. safe and low cost metodology (1992) Clin Int Care, 3 (SUPPL.), p. 112Graf, C.J., Rossi, N.P., Pulmonary oEdema and central nervous system.A clinico-pathological study (1975) Surg Neurol, 4, pp. 319-325Kauffman, H.H., Timberlake, G., Voelker, J., Glenn, P.T., Medical complications of head injury (1993) Med Clin North Am Jan, 70, pp. 43-60Knudsen, F., Jensen, H.P., Peterson, P.L., Neurogenic Pulmonary Edema treatment with dobutamine (1991) Neurosurgery, 29, pp. 269-270Li, C., Gefter, W.B., Acute Pulmonary Edema induced by overdosage of phenothiazines (1992) Chest, 101, pp. 102-104Malik, A.B., Mechanisms of neurogenic Pulmonary Edema (1985) Circ Res, 57, pp. 1-18Melone, E., Bonnet, F., Lepreslo, E., Fevrier, M.J., Djindjian, M., Francois, Y., Gray, F., Debras, C., Altered capillary permeability in neurogenic Pulmonary Edema (1985) Int Care Med, 11, pp. 323-325Murphy, P.G., Jackson, R., Kirollos, R., Gibson, J.S., Chennells, P., Adult respiratory distress syndrome after attenuated strangulation (1993) Br J Anasth, 70, pp. 583-586Pender, E.S., Pollack, C.V., Neurogenic Pulmonary Edema: Case reports and review (1992) J Em Med, 10, pp. 45-51Pollack, V., Pollack, E.S., Neurogenic Pulmonary Edema (1993) J Emerg Med, 11, pp. 207-210Simmons, R.L., Martin, A.M., Heisterkamp, C.A., Ducher, T.B., Respiratory insufficiency in combat casualties. II Pulmonary Edema following head injury (1969) Ann Surg, 170, pp. 39-41Simon, R.P., Neurogenic Pulmonary Edema (1993) Neurol Clin, 11, pp. 309-323Simon, R.P., Medullary lesion inducing Pulmonary Edema a magnetic resonance imaging study (1991) Ann Neurol, 30, pp. 727-730Toucho, H., Kavasawa, J., Sishido, H., Yamada, K., Yamazaki, Y., Neurogenic Pulmonary Edema in the acute stage of hemorrhagic cerebrovascular disease (1989) Neurosurgery, 25, pp. 762-768Wauchob, T.D., Brooks, R.J., Harrison, K.M., Neurogenic Pulmonary oEdema (1984) Anaesthesia, 39, pp. 529-534Wright, R.S., Feuerman, T., Brown, J., Neurogenic Pulmonary Edema after trigeminal nerve blockade (1989) Chest, 96, pp. 436-43
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Neurogenic Pulmonary Edema: Report Of Two Cases [Edema Pulmonar Neurogênico: Relato De Dois Casos]
2015Co-Authors: Dragosavac D, Araújo S, Falcao A.l.e., Terzi R.g.g.Abstract:Neurogenic Pulmonary Edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic Pulmonary Edema, one with head injury and other with intracerebral hemorrhage Diagnosis was made by rapid onset of Pulmonary Edema, severe hypoxemia, decrease of Pulmonary complacence and diffuse Pulmonary infiltrations, without previous history of tracheal aspiration or any other risk factor for developement of adult respiratory distress syndrom In the first case, with severe head trauma, neurogenic Pulmonary Edema was diagnosed at admission one hour after trauma, associated with severe systemic inflammatory reaction. and good outcome in three days. The second case, with hemorragic vascular insult, developed neurogenic Pulmonary Edema the fourth day after drenage of intracerebral hematom and died
Stephane Cook - One of the best experts on this subject based on the ideXlab platform.
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salmeterol for the prevention of high altitude Pulmonary Edema
The New England Journal of Medicine, 2002Co-Authors: Claudio Sartori, Yves Allemann, Herve Duplain, Mattia Lepori, Marc Egli, Ernst Lipp, Damian Hutter, Pierre Turini, Olivier Hugli, Stephane CookAbstract:Background Pulmonary Edema results from a persistent imbalance between forces that drive water into the air space and the physiologic mechanisms that remove it. Among the latter, the absorption of liquid driven by active alveolar transepithelial sodium transport has an important role; a defect of this mechanism may predispose patients to Pulmonary Edema. Beta-adrenergic agonists up-regulate the clearance of alveolar fluid and attenuate Pulmonary Edema in animal models. Methods In a double-blind, randomized, placebo-controlled study, we assessed the effects of prophylactic inhalation of the beta-adrenergic agonist salmeterol on the incidence of Pulmonary Edema during exposure to high altitudes (4559 m, reached in less than 22 hours) in 37 subjects who were susceptible to high-altitude Pulmonary Edema. We also measured the nasal transepithelial potential difference, a marker of the transepithelial sodium and water transport in the distal airways, in 33 mountaineers who were prone to high-altitude Pulmonary ...
Abhimanyu Garg - One of the best experts on this subject based on the ideXlab platform.
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thiazolidinedione associated congestive heart failure and Pulmonary Edema
Mayo Clinic Proceedings, 2003Co-Authors: Asra Kermani, Abhimanyu GargAbstract:OBJECTIVE To evaluate the effect of thiazolidinediones on the development of cardiac failure and Pulmonary Edema during treatment of type 2 diabetes mellitus. Patients and Methods We retrospectively reviewed the medical records of 6 men (aged 66 to 78 years) treated at our institution between August 1, 2001, and May 21, 2002, who had type 2 diabetes and developed signs and symptoms of congestive heart failure and Pulmonary Edema after 1 to 16 months of therapy with pioglitazone or rosiglitazone. Results Four patients had chronic renal insufficiency; only 1 had ischemic cardiomyopathy. Symptoms resolved promptly in all 6 patients after administration of diuretics and discontinuation of the thiazolidinedione. Conclusion We conclude that thiazolidinediones can cause or exacerbate heart failure and Pulmonary Edema and should be avoided in patients with left ventricular dysfunction or chronic renal insufficiency.
