Pulmonary Oedema is accumulation of fluid in lungs. It can be due to cardiogenic or non-cardiogenic causes. This presentation was a class presentation and discussed its management alongwith diagnosis.

1. B Y : D R . H A S E E B T A R I Q
Pulmonary Oedema

2. Definition
Pulmonary oedema is a condition characterized by
fluid accumulation in the lungs caused by
extravasation of fluid from pulmonary vasculature in
to the Interstitium and alveoli of Lungs.

3. The extent to which the fluid accumulation occurs in
the interstitium depends on:
 Hydrostatic pressure ( favors movement into
interstitium)
 Oncotic Pressure ( favors movement into
capillary)

4. CLASSIFICATION
According to cause pulmonary oedema is classified as:
 Cardiogenic Pulmonary Oedema
 Non Cardiogenic Pulmonary Oedema
 High altitude Pulmonary Oedema (HAPE)

5. Cardiogenic Pulmonary Oedema
It is due to increased pulmonary venous &
pulmonary capillary pressure which pushes the
fluid in interstitium & alveoli.
Following are the causes:
 Left Ventricle Failure
 Dysrhythmia
 LV hypertrophy & Cardiomyopathy
 Myocardial Infarction
 Left Ventricle Outflow obstruction

6. Non-Cardiogenic Pulmonary Oedema
It is caused due to following main reasons:
 Direct injury to lung
 Hematogenous injury to lung
 Lung injury + Elevated hydrostatic pressure

8. SIGNS & SYMPTOMS
 DYSPNEA
 TACHYPNEA
 TACHYCARDIA
 CYANOSIS
 FROTHY SPUTUM
 WHEEZING
 CRACKLES
 SUDDEN WEIGHT GAIN
 DECREASED URINARY OUTPUT

9. DIFFERENTIAL DIAGNOSIS
 PNEUMOTHORAX
 BRONCHITIS
 CARDIAC TAMPONADE
 COPD
 PERICARDITIS
 PNEUMONIA

10. INVESTIGATIONS
 CXR-PA view
 ABGs:
 Initially Resp.Alkalosis with hypocapnia & hypoxia
 LaterHypercapnea
 Blood workup
 Septic screen

11. Chest X-Ray Appearance
 B/L perihilar Bat’s Wing appearence
 Symmetric opacification of lung fields
 Kerley B lines or Septal lines
 Cardiomegaly
 Peribronchial Cuffing

13. ABGs Report
 Respiratory Alkalosis

14. MANAGEMENT
 Give Oxygen.
 Treat the underlying cause.
 Respiratory support (Non-Invasive ventilation,
Intubation)
 CPAP
 Diuretics
 Nitrates

15. High Altitude Pulmonary Oedema
 Occurs in young people who ascend quickly to
2700m or above & perform strenous exercise
 Reversible in nature
 Low oxygen concentration at high altitudes causes
pulmonary vasoconstriction
 Mean pulmonary artery pressure rises
 Alveolar capillary membrane is damaged leading to
oedema

16. Signs & Symptoms:
 SOB
 HEADACHE
 INSOMNIA
 FLUID RETENTION
TREATMENT:
 Rapid descent to lower altitudes & administration of
oxygen if required.
 The medications Acetazolamide, Dexamethasone,
or Nifedipine may also be used for prevention.

17. THANK YOU