Acute pulmonary edema is the cause of death. Symptoms of pulmonary edema and therapy

Acute pulmonary edema is a violation of the circulation of blood and lymph, which causes active release of liquid from the capillaries into the tissue of this organ, which eventually provokes a disturbance of gas exchange and leads to hypoxia. Acute edema builds up quickly (the duration of an attack from half an hour to three hours), which is why even with time to begin resuscitation, it is not always possible to avoid a lethal outcome.

How is development of acute pulmonary edema

Acute pulmonary edema - the cause of death of many patients - develops as a result of infiltration of blood serum into the lung tissue, where it is collected in such a quantity that the airflow possibilities greatly diminish.

In the beginning, this edema has the same character as the swelling of other organs. But the structures that surround the capillaries are very thin, which causes the fluid to immediately enter the cavity of the alveoli. By the way, it appears in the pleural cavities, however, to a much lesser extent.

Diseases that can cause acute pulmonary edema

Acute pulmonary edema is the cause of death during the course of many diseases, although in some cases it can still be stopped with the help of medications.

Diseases that can provoke pulmonary edema include pathologies of the cardiovascular system, including cardiac muscle damage in hypertension, congenital malformations and congestion in the large circulation.

No less frequent causes of pulmonary edema are severe skull injuries, hemorrhages in the brain of different etiologies, as well as meningitis, encephalitis and various brain tumors.

It is natural to assume the cause of pulmonary edema and in diseases or lesions of the respiratory system, such as pneumonia, inhalation of toxic substances, trauma to the chest, allergic reactions.

Surgical pathologies, poisoning, insulin shock and burns can also lead to the described edema.

Types of pulmonary edema

Patients most often observe two main, cardinally different types of pulmonary edema:

• Cardiogenic (cardiac pulmonary edema) caused by left ventricular failure and stagnation of blood in the lungs;
• Non-cardiogenic caused by increased permeability, acute damage to the organ or acute respiratory distress syndrome;
• A non-cardiogenic type of toxic edema is considered separately.

However, despite the fact that the causes of their occurrence are different, these swelling can be very difficult to differentiate because of similar clinical manifestations of the attack.

Pulmonary edema: symptoms

Emergency care provided with swelling of the lungs in time, still gives the patient a chance to survive. For this it is important to know all the symptoms of this pathology. They are quite bright and easy to diagnose.

• At the beginning of the attack, the patient often coughs, his hoarseness grows, and the face, nail plates and mucous membranes become bluish.
• Choking increases, accompanied by a feeling of tightness in the chest and pressing pain. To facilitate the patient is forced to sit down and sometimes lean forward.
• Very quickly, the main signs of pulmonary edema are manifested: rapid breathing, which becomes hoarse and bubbling, there is weakness and dizziness. The veins in the neck region swell.
• When you cough, pink foamy sputum appears. And if the condition worsens, it can stand out from the nose. The patient is afraid, his mind can be confused. The limbs, and then the entire body become wet from cold sticky sweat.
• The pulse speeds up to 200 beats per minute.

Features of toxic pulmonary edema

A slightly different picture is toxic pulmonary edema. It is caused by poisoning with barbiturates, alcohol, and also penetration into the body of poisons, heavy metals or nitric oxides. Burning lung tissue, arsenic poisoning, uremia, diabetic, hepatic coma can also provoke the described syndrome. Therefore, any severe attack of suffocation, which appeared in these situations, should make one suspect pulmonary edema. Diagnosis in these cases should be thorough and competent.

Toxic edema often occurs without any characteristic symptoms. For example, with uremia, very meager external signs in the form of chest pain, dry cough and tachycardia do not correspond to the picture seen during X-ray examination. The same situation is typical for toxic pneumonia, and in case of poisoning with metal carbonates. And poisoning with nitrogen oxides can be accompanied by all the signs of edema described above.

The first non-drug treatment for pulmonary edema

If the patient is found to have accompanying pulmonary edema symptoms, emergency care must be provided before placement in the intensive care unit. Necessary measures are carried out by an ambulance team on the way to the hospital.

• The patient is given a semi-sitting position.
• On it unbuttoned tight clothes, from the upper respiratory tract remove the foam. And to prevent its formation, oxygen inhalation is carried out through a 30% solution of ethyl alcohol together with intravenous injection of 15 ml of glucose solution. In case of strong release of foam, endotracheal administration of 2 ml of ethyl alcohol (96%) is carried out by means of a puncture of the trachea.
• One of the fastest ways to reduce pressure in a small circle of blood circulation is bloodletting. As a rule, 300 ml of blood is extracted, significantly reducing the congestion in the lungs. But with arterial hypotension or a heart attack that caused pulmonary edema, the consequences of this procedure can be severe.
• As an alternative to bloodletting, the application of moderately tight tourniquets to 4 limbs acts, which also facilitates unloading of the small circle of blood circulation. In this case, it is necessary to check the pulsation below the bundles and keep them no more than half an hour, after which the tows should be weakened, and then applied again. A direct contraindication for this procedure is thrombophlebitis.

Medication for swelling of the lungs

The variety of manifestations accompanying the attack, led to the fact that in medicine, many medications are used, which can remove acute edema of the lungs. The cause of death in this case can be covered not only in the most pathological condition, but also in improperly selected treatment.

One of the drugs used to stop edema is morphine. It is especially effective in case the attack was caused by hypertension, mitral stenosis or uremia. Morphine reduces dyspnea, inhibiting the respiratory center, relieves stress and anxiety in patients. But at the same time he is able to increase intracranial pressure, why use it in patients with impaired cerebral circulation should be very cautious.

To reduce the hydrostatic intravascular pressure with pulmonary edema, intravenously drugs "Lasix" or "Furosemide" are used. And to improve the pulmonary blood flow, heparin therapy is used. Heparin is administered bolus (jet) in a dose of up to 10,000 units intravenously.

Cardiogenic edema, in addition, requires the use of cardiac glycosides ("Nitroglycerin"), and non-cardiogenic - glucocorticoids.

Strong pains are removed with the help of preparations "Fentanyl" and "Droperidol". If you manage to stop the attack, the therapy of the underlying disease begins.

Pulmonary edema: effects

Even if the cupping of the pulmonary edema was successful, the treatment does not end there. After such an extremely serious condition for the whole body, patients often develop serious complications, most often in the form of pneumonia, which in this case is very difficult to treat.

Oxygen starvation affects almost all the organs of the victim. The most serious consequences of this may be disorders of cerebral circulation, heart failure, cardiosclerosis and ischemic organ damage. These conditions do not do without constant and strengthened drug support, they, in spite of the cured acute edema of the lungs, are the cause of the death of a large number of patients.