By ;- ROGER BEN BSC.NURSING

1. PULMONARY EDEMA
By :-
F.Roger
Ben

2. DEFINITION :-
Pulmonary edema
can be defined as
the condition in
which there is an
accumulation of
fluid in interstitium
and alveoli of
lungs.

3.  The fluid accumulation in interstitium
depends on balance between hydrostatic
and oncotic pressure.
 Hydrostatic – movement of fluids from
capillary to interstitium.
 Oncotic – fluid movement towards the
vessel.
 Incidence :-
1. 40 to 75 yrs ( males).
Cont..

4. STAGING OF PULMONARY EDEMA:-
Stage 1:- excess fluids cleared by lymphatic
drainage.
Stage 2:- Presence of interstitial edema.
Stage 3:- alveolar edema due to altered alveolar
capillary permeability.
1. Mild :- enlargement of Pulmonary vasculature.
2. Moderate:- extravasation of fluid into interstitial
space due to oncotic pressure.
3. Severe :- alveolar filling occur.

5. TYPES OF PULMONARY EDEMA:-
Cardiogenic pulmonary
edema :-
Either due to direct
damage of cardiac tissue
or result of inadequate
functioning of heart or
circulatory system.

6. Causes of cardiogenic pulmonary
edema:-
Congestive heart
failure. (CHF).
Severe arrhythmias.
Hypertension.
Fluid overload due to
kidney failure (or)
intravenous therapy.

7. Cont....
NON – CARDIOGENIC
PULMONARY EDEMA:-
Radiographic evidence of
alveolar fluid
accumulation without
evidence to suggest
cardiogenic etiology.

8. Causes of non- cardiogenic pulmonary
edema:-
Inhalation of toxic
gases.
Aspiration of gastric
fluids ( in case of
drowning).
Multiple blood
transfusion.
Severe infections.

10. PATHOPHYSIOLOGY:-
 Imbalance of starling force.
 Increase of pulmonary capillary
pressure.
 Decrease of plasma oncotic
pressure.
 Increase of negative interstitial
pressure.
 Damage to the alveolar- capillary
Barrier.
 Lymphatic obstruction.

11. SYMPTOMS OF PULMONARY EDEMA:-
 Acute pulmonary edema:-
1. Shortness of breathe.
2. Suffocation .
3. Anxiety.
4. Cough with froothy sputum.
5. Excessive sweating.
6. Pale skin.
7. Chest pain.
8. Palpitation.

12. Cont...
Chronic pulmonary
edema:-
1. Paraxosomal nocturnal
dyspnea.
2. Orthopnea.
3. Weight gain.
4. Loss of appetite.
5. Swelling in the ankle and
neck.

13. Diagnostic Evaluation :-
History collection.
Physical examination.
ABG analysis.
Chest X-RAY.
ECG ( valvular disease).
Blood culture.
Pulmonary artery wedge
pressure (Swan gauze
catheter).
Cardiac markers. (MI)

14. MANAGEMENT OF PULMONARY
EDEMA:- Improve oxygen and reduce pulmonary
congestion.
 Oxygen Therapy :- Rebreather mask /ET
tube intubation & mechanical ventilation.
 High Fowler’s position.
 Morphine.
 Diuretics.
 Vasodilation.
 Dopamine, Dogoxin & Dobutamine
 Aminophylline.

15. Nurse’s role :-
Help the patient to relax and
promote oxygen.
High fowler’s position to enhance
lung expansion.
Record time and amount of morphine
when administered.
Auscultate lung sounds (crackles).
Monitor ABG ( hypoxemia &
hypercapnia).

16. Cont...
Monitor the Intake & output
chart.
Provide calm environment
Asses the edema in ankles and
sacrum.
Note for complications for
further treatment such as
electrolyte imbalance.
Keep the emergency equipments
ready, such as airway , ambu bag

18. QUIZ :-
1. What is pulmonary edema ?
2. What is the diagnostic Evaluation?
3. Management of pulmonary edema?