On pulmonary edema Pulmonary edema is the excessive accumulation of extravascular lung fluid in the interstitial space (interstitial edema) or in the alveoli (alveolar edema).
pulmonary edema, therefore, develops as a consequence of any alteration that causes an imbalance between the formation and drainage of fluids.
CAUSES OF LUNG EDEMA
1. Increased capillary hydrostatic pressure
may be due to fluid overload (eg by inadequate fluid therapy) or heart
2. Increased capillary permeability
is a consequence of various lung disorders and / or systemic. An example is the ARDS (Acute Respiratory Distress Syndrome). ARDS is a form of pulmonary edema, characterized by acute or hyperacute presentation with rapid progression of symptoms. Is associated with multiple pulmonary disorders and / or systemic (pancreatitis, uremia, sepsis, trauma, drugs or toxins)
3. Decreased lymphatic drainage. This is usually of neoplastic origin.
4. Decrease in interstitial pressure (Although their importance in clinical practice is unclear
5. Decreased oncotic pressure
a) hydration
b) Hypoproteinemia (rare causing symptoms by itself but can worsen or ease its appearance in the presence of other predisposing factors)
; I. Renal
II. Inflammatory bowel disease
; III. liver failure
6. Other ...
neurogenic edema is a type of edema whose causes have not been fully elucidated, however seems clear that in these cases there is both an increase in hydrostatic pressure and increased capillary permeability. It is a rare condition in cats but not in both dogs and is associated with head injuries, seizures, increased intracranial pressure as well as obstruction of the upper airways.
DIAGNOSIS Clinical signs that may be encountered during the examination include: tachypnea, dyspnea, and crackles.
Chest x-ray can be found different patterns according to cause lung, the time elapsed since its occurrence or severity picture:
- alveolar skull-ventral pattern: it is compatible with aspiration pneumonia
- interstitial or alveolar pattern dorsocaudal: compatible with neurogenic pulmonary edema
- Perihilar region alveolar pattern: compatible with cardiogenic edema in dogs. In cats may also show an perihilar edema but may also patched a pattern that can sometimes appear nodular.
The chest radiograph is important to note whenever the size of the pulmonary veins in normal conditions. Should not exceed 70-75% of the diameter of the first dorsal third of the fourth rib. An increase indicates an increase in venous pressure is a key finding in the diagnosis of edema of congestive heart failure.
cardiophats In a simple way to prevent the occurrence of severe pulmonary edema is to urge patients
respiratory frequency estimation home.
TREATMENT Treatment varies depending on the cause but certainly supplement with oxygen and to avoid any kind of stress is fundamental to any kind of moderate-severe edema.
In cardiogenic pulmonary edema is the mainstay of treatment aimed at reducing pulmonary capillary pressure by decreasing cardiac preload. This is used primarily for two types of drugs: diuretics and vasodilators. Within
of diuretics has very important significance of furosemide and has seen its most effective when used in continuous infusion.
Within very effective vasodilator nitroprusside, although not without risk and that is a potent vasodilator that can cause hypotension and it is therefore imperative to assess the patient regularly.