Pulmonary edema is a condition characterized by fluid accumulation in the lungs, making breathing difficult and interfering with gas exchange, which can lead to respiratory failure. It can be caused by cardiogenic factors like congestive heart failure or non-cardiogenic factors such as Acute Respiratory Distress Syndrome (ARDS), pneumonia, and trauma. Diagnosis involves clinical exams and imaging, while management includes providing oxygen, pharmacologic therapies, and monitoring for severe cases requiring emergency intervention.

1. Pulmonary
Edema

2. Pulmonary edema occurs
when fluid accumulates in the
air sacs of the lungs-the
alveoli-making it difficult to
breathe. This interferes with
gas exchange and can cause
respiratory failure

4. During normal breathing, the small air sacs
in the lungs, the alveoli, fill up with air.
Oxygen is taken in, and carbon dioxide is
expelled. If the alveoli are flooded with liquid,
two problems occur:
1. The bloodstream cannot get enough
oxygen,
2. The body is unable to get rid of carbon
dioxide properly.

5. Pulmonary edema can be
acute (sudden onset) or
chronic (occurring more
slowly overtime).

6. Causes
i) cardiogenic cause
1)congestive heart failure (In this condition, the left ventricle
cannot pump out enough blood to meet the needs of the body.
This causes a buildup of pressure in other parts of the
circulatory system, forcing fluid into the air sacs of the lungs
and other parts of the body.
2) other Heart problems including
_Fluid overload
_Hypertension emergency
_pericardial effusion
_severe arrhythmias
_severe heart attack
_abnormal heart valve

7. ii) non cardiogenic cause is ARDS
iii) other common causes include
Pneumonia
Sepsis (blood infection)
Exposure to some chemicals
Near drowning
Inflammation
Trauma
Reaction to certain medications
Drug overdose.
&Besides direct injury to the lungs, as in ARDS, other
causes include:
.Brain injuries such as brain bleeding, stroke, head injury, brain
surgery, tumor, or seizure.
.High altitude.

8. Clinical manifestation
Acute pulmonary edema causes significant breathing
difficulties and can appear without warning. This is an
emergency and requires immediatel medical attention as it can
be fatal if not treated. The others signs and symptoms
include:-
Cough-often with pink frothy sputum
Excessive sweating
Anxiety & restlessness
Feeling of suffocation
Pale skin
Wheezing
Rapid &irregular heart rhythm
Chest pain

9. If the pulmonary edema is chronic, symptoms are
typically less severe until the body's system can no
longer compensate. Typical symptoms include:
.Difficulty breathing when lying flat (orthopnea).
.swelling (edema) of feet or legs.
.Rapid weight gain due to the accumulation of
excess fluid
.Paroxysmal nocturnal dyspnea-episodes of
severe sudden breathlessness at night.
.Fatigue.
. Increased breathlessness with physical activity

10. Diagnosis
Physical exam and auscultation of chest and listen to the lungs for
crackles and rapid breathing, and the heart for abnormal rhythms.
Blood tests will be carried out to determine blood oxygen levels,
kidney and liver function, blood counts, and blood markers of heart
failure.
An ultrasound of the heart, an echocardiogram, and an
electrocardiogram (EKG) can help determine heart condition and
function.
A chest X-ray may be used to see whether there is any fluid in or
around the lungs and to check the size of the heart. A CT scan of
the chest may also be ordered

11. Management
Oxygenation
Oxygen in concentrations adequate to relieve hypoxia and dyspnea
Oxygen by intermittent or continuous positive pressure, if signs of
hypoxemia persist
• Endotracheal intubation and mechanical ventilation, if res- piratory failure
occurs
• Positive end-expiratory pressure (PEEP)
Monitoring of pulse oximetry and ABGS

12. Pharmacologic Therapy
Morphine given intravenously in small doses to reduce
anx- iety and dyspnea; contraindicated in cerebral
vascular acci- dent, chronic pulmonary disease, or
cardiogenic shock; have naloxone hydrochloride
(Narcan) available for excessive respiratory depression
•Diuretics (eg, furosemide) to produce a rapid diuretic
effect
.Vasodilators such as IV nitroglycerin or nitroprusside
(Nipride) may enhance symptom relief

13. Thankyou