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3.6.6 - Pulmonary Oedema
from Section 3.6 - Acute Respiratory Failure
- By Marc Zentar, Kate Tatham
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 238-241
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Summary

Key Learning Points
1. Pulmonary oedema occurs when pulmonary capillary membrane permeability or hydrostatic pressure is increased.
2. Pulmonary oedema is categorised as either cardiogenic or non-cardiogenic, and early diagnosis of the underlying cause is key.
3. Patients with cardiogenic pulmonary oedema secondary to acute heart failure are often hypovolaemic/euvolaemic, and treatment with diuretics is associated with increased mortality, myocardial infarction and the need for mechanical ventilation. Vasodilators and prompt consideration of non-invasive ventilation are advised.
4. In patients with cardiogenic shock secondary to chronic decompensated heart failure, diuresis and prompt consideration of non-invasive ventilation are advised.
5. In patients with non-cardiogenic pulmonary oedema, the role of non-invasive ventilation is less clear and early endotracheal intubation should be considered.