What causes pulmonary edema. What are the symptoms of pulmonary edema? Questions for the state exam in therapy

Edema that appeared on various parts bodies, signal the presence of certain health problems. They are hidden and obvious, are painless or cause discomfort. Serious pathologies of vital organs can provoke swelling and death.

Diseases that cause fatal edema

Edema is an excessive accumulation of fluid in the intercellular spaces of soft tissues. Pathology is formed by different reasons. Violation of carbohydrate and protein metabolism, disorder endocrine system, allergic reactions and infectious diseases provoke edematous syndromes of varying severity.

There are especially dangerous states when pathology can lead to lethal outcome. They appear in the background chronic diseases heart muscle, significant intoxication of the body, allergic reactions.

Diseases that provoke edema - the causes of death are presented in the table.

Any of these conditions, in the absence of medical assistance, can lead to death.

Leads to edema pulmonary insufficiency with the passage of fluid from the capillaries to the alveoli. An organ filled with water does not cope with its functions. As a result, suffocation develops, pain in chest area, cardiopalmus. Without help, death from pulmonary edema can occur.

Pathology is divided into 2 types:

• Hydrostatic edema - occurs due to intravascular pressure with the release of fluid from blood vessels into the alveolus
• Membrane - develops as a result of exposure to toxins on the walls of the lungs with the release of fluid into the lung space.

Depending on the course of the process, pulmonary edema is divided into:

• Lightning - proceeds intensively, ending in death in a few minutes;
• Acute - the body is quickly filled with fluid, the process takes a short period of time. Lethal outcome occurs in 2-3 hours.
• Subacute - proceeds in waves;
• Prolonged - passes hidden, without visible symptoms. The lungs fill with fluid gradually over several days.

The most common death is from pulmonary edema with heart disease. The complication occurs as a result of circulatory disorders in the arteries and blood vessels. The alveolus of the lungs has many capillaries that cause it to contract and produce gas exchange. If the work of the heart muscle is disturbed, blood stagnation occurs, part of the alveoli ceases to do its job, with a deterioration in gas exchange, a lack of oxygen occurs. Gradually, the alveoli begin to let blood flow inside, pulmonary edema sets in, the cause of death of many people with ischemic diseases, heart failure, and myocardial infarction.

Symptoms, emergency care and consequences

Symptoms of pulmonary edema appear suddenly. At first, a person does not have enough air, breathing quickens, characteristic bubbling sounds appear, coughing with sputum, cold sweat, rises arterial pressure. The patient's consciousness begins to get confused, the pulse becomes weak, swelling of the veins in the neck occurs.

In this condition, a person needs emergency care, therefore, before the arrival of the medical team, it is necessary:

• Give the patient a sitting position;
• Open windows and vents for free air access;
• Unfasten clothing and belts that are squeezing chest;
• Put a Nitroglycerin tablet under the patient's tongue;
• Give a strong diuretic;
• Apply tourniquets (keep no more than 20 minutes) on upper part right thigh to reduce blood flow to the heart.

Those who have undergone pulmonary edema often develop serious complications: pneumonia, which is difficult to treat, hypoxia, cerebrovascular accident, heart failure, ischemic lesion organs.

Treatment

the main objective intensive care aimed at removing swelling. You can stop edema in the following ways:

• Sedative therapy;
• Foam suppression;
• Vasodilator drugs;
• Diuretics;
• Heart medications.

After removal dangerous symptoms eliminate the causes of the pathology that has arisen.

Note. After an edematous syndrome of any etiology, the patient is hospitalized and without fail are treated with strong antibiotics and antiviral agents.

cerebral edema

The rapid accumulation of fluid in the cerebral tissues causes cerebral edema. Nerve cells fill with water and increase in size, causing pressure on the bones of the skull. As a result, an increase intracranial pressure, disruption of blood flow and metabolic processes. Pathology develops rapidly, provoking death from cerebral edema.

The main causes of cerebral edema:

• head trauma;
• Hemorrhages in the brain;
• allergic reactions;
• Intoxication of the body;
• Infections.

Symptoms of a condition with swelling of the brain:

• Severe headaches;
• Violation of attention, absent-mindedness, loss of orientation;
• Insomnia;
• high fatigue;
• Depression;
• Violation of the visual and hearing aids;
• Paralysis of the limbs;
• Decreased heart rate;
• convulsions;
• clouding of consciousness;
• Respiratory failure;
• Coma.

Note.Death from cerebral edemamay occur due to respiratory arrest in a coma.

Before the arrival of the ambulance, you must carefully monitor the pulse and lung function. AT emergency heart massage and artificial respiration.

If a conservative help was provided on time, the prognosis will be positive. Medium severity pathological process accompanied by headaches, fatigue, convulsive syndromes.

Cerebral edema - serious pathology requiring urgent liquidation. Any delay may result in irreversible consequences when the medical report says: the cause of death is cerebral edema.

Quincke's edema

As a result of the allergen entering the body, severe swelling of the mucous membranes, called Quincke, can develop. If the development of pathology occurred in the larynx, asphyxia (suffocation) often occurs. Therefore, without stopping the attack, Quincke's edema can lead to the death of a person.

There are 2 types of described pathology:

• Allergic - occurs when an allergen enters the body;
• Pseudo-allergic - congenital. It is formed as a response of the body to various stimuli: heat, cold, chemical components.

Symptoms of Quincke's edema depending on organ damage

With Quincke's edema, it is imperative to call ambulance. If the patient has anaphylactic shock, without fail, perform cardiac resuscitation and artificial respiration. Treatment is symptomatic. main goal now is the restoration of airway patency. In case of an allergic reaction, antihistamines and glucocorticoids, prescribe diuretics.

The prognosis of angioedema depends on the severity of the allergic reaction and timely assistance to the victim. With an increase in the larynx and tongue, suffocation and death are possible.

Abdominal edema

In the near-death state, bedridden patients often experience swelling. Due to disruption of the vital organs, the legs swell before death. Failure of the kidneys leads to fluid retention in the body. Swelling of the legs before death due to cirrhosis is often accompanied by ascites. Ascites is an accumulation of fluid in the abdominal cavity. It develops due to renal and hepatic failure. Pathology does not lead to death, but complicates the work of everyone internal organs. A diseased organ (liver) does not produce albumins, which retain liquid part blood in vessels. Their decrease leads to the accumulation of water in internal tissues. Constant compression improves intra-abdominal pressure and increases blood outflow obstruction lower extremities causing edema.

Pulmonary edema is a serious condition associated with the accumulation of fluid outside the pulmonary blood vessels. If first aid is not provided for pulmonary edema and timely treatment, then this condition can lead to the death of the patient.

The structure of the lung is a thin-walled sac covered with capillaries. This structure ensures rapid gas exchange. Pulmonary edema occurs when the alveoli fill with fluid instead of air that leaks from the blood vessels. Initially, edema develops in the interstitium (interstitial pulmonary edema), then extravasation develops in the alveoli (alveolar pulmonary edema).

The main causes of pulmonary edema are stagnation in the pulmonary circulation and destruction of the vessels of the lungs.

The main causes of pulmonary edema are stagnation in the pulmonary circulation and destruction of the vessels of the lungs.

The causes of pulmonary edema, in most cases, are associated with pathology and acute overload of the heart, in which case cardiogenic pulmonary edema develops. The following diseases can provoke cardiogenic pulmonary edema: left ventricular dysfunction, left atrial systole disorders, diastolic dysfunction and systolic dysfunction.

Also, pulmonary edema can occur when the alveolocapillary membranes are damaged. toxic substances, such edema is called toxic. allergic edema lungs cause products of an allergic reaction.

Pulmonary edema can be caused by the following diseases and conditions:

• Diseases of the cardiovascular system (myocardial infarction, postinfarction cardiosclerosis, atherosclerotic cardiosclerosis, heart disease, aortic aneurysm, and so on);
• lung diseases (pneumosclerosis, Chronical bronchitis, lung tumors, pulmonary tuberculosis, pneumonia, fungal infections of the lungs);
• Diseases accompanied by intoxication (measles, influenza, scarlet fever, diphtheria, acute laryngitis, chronic tonsillitis, whooping cough);
• Mechanical obstacles to the entry of air into the respiratory tract (water entering the lungs, a foreign body into the respiratory tract, suffocation with vomit);
• Uncontrolled medication intake, massive heartburn, alcohol intoxication, poisoning, narcotic intoxication, finding long time on the machine artificial respiration may also cause pulmonary edema.

Forms of the disease

Depending on the rapidity of development, several forms of pulmonary edema are distinguished.

Depending on the rapidity of development, several forms of pulmonary edema are distinguished:

• Acute pulmonary edema develops in 2-3 hours;
• Fulminant pulmonary edema is characterized by the onset of a detailed outcome within a few minutes;
• Prolonged pulmonary edema develops over several hours or days.

The first symptoms of pulmonary edema

Signs of pulmonary edema appear suddenly: during the day when a person makes physical effort or at night when he sleeps

Signs of pulmonary edema appear suddenly: during the day, when a person makes physical efforts or at night, when he sleeps. The initial symptoms of pulmonary edema are manifested by frequent coughing, increased wheezing, and a change in complexion. Then the patient begins to feel severe suffocation, tightness in the chest, pressing pain, while breathing quickens and bubbling rales can be heard at a distance.

During a cough, frothy pink sputum begins to depart; in a serious condition, foam begins to come out of the nose. It becomes difficult for the patient to inhale and exhale air, cyanosis of the skin appears, neck veins swell, and cold sweat emerges. The pulse sharply quickens to 140-160 beats per minute. During an attack, damage to the upper respiratory tract can occur, a lumpy state and death can occur.

If the patient has symptoms of pulmonary edema, an ambulance should be called immediately.

Diagnosis of the disease

Pulmonary edema is usually diagnosed with a chest x-ray.

Pulmonary edema is usually diagnosed with a chest x-ray. At normal condition the lungs in the picture look like dark areas, and with pulmonary edema, atypical enlightenment of the lung fields is observed. In severe cases, a significant clouding appears on the image, which indicates the filling of the pulmonary alveoli with fluid.

To determine the cause of the disease, it is necessary to observe the clinical picture of the patient. For this purpose, a general examination is carried out, anamnesis data are studied and general examination. Plasma concentrations of both N-terminal propeptide and type B natriuretic peptide are also analyzed to make a diagnosis. In severe situations, it may be necessary direct measurement pressure in the pulmonary vessels. In such a study, large veins a thin long tube is inserted into the chest or neck - the Swan-Ganz catheter, which allows you to determine the causes of the development of pulmonary edema.

Before carrying out full therapy, the patient should be immediately provided with first aid for pulmonary edema

Before carrying out full therapy, the patient should be immediately provided with first aid for pulmonary edema:

• It is necessary to ensure that a person in a state of attack lies or sits;
• From the upper respiratory tract, the existing fluid should be aspirated;
• At high blood pressure bloodletting is carried out: 100-200 milliliters of blood is released for children, and 200-300 milliliters for adults;
• A tourniquet is applied to the legs for 30-60 minutes;
• Alcohol vapors are inhaled: children are inhaled with 30% alcohol, and adults with 70% alcohol;
• 2 milliliters of a 20% camphor solution are administered subcutaneously;
• The respiratory tract is enriched with oxygen using an oxygen cushion.

Treatment of pulmonary edema

In the hospital, emergency care consists of bloodletting, the introduction of cardiac glycosides, Lasix or Novurit, and the continuation of oxygen therapy

In the hospital, emergency care consists of bloodletting, the introduction of cardiac glycosides, Lasix or Novurit, and the continuation of oxygen therapy.

After stabilization of the patient's condition, treatment of pulmonary edema begins, aimed at eliminating the cause of the attack. For this purpose, drugs are prescribed that reduce peripheral vascular resistance, normalize the work of the heart and improve the metabolic process in the myocardium.

Also, the treatment of pulmonary edema is aimed at carrying out activities that contribute to the compaction of the capillary-alveolar membranes. Often used during treatment sedatives to remove the patient from stressful situation and normalize it psychological state. Such drugs not only improve the emotional background of the patient, but also reduce vascular spasms, improve heart function, reduce shortness of breath, and normalize the penetration of tissue fluid through the capillary-alveolar membrane. An effective sedative is morphine, a 1% solution of morphine is administered intravenously during treatment in a volume of 1-1.5 milliliters. In some cases, it allows you to completely eliminate edema.

Timely treatment of the disease is very important, because the consequences of pulmonary edema can be very serious - oxygen starvation of all organs can occur, including vital important body- brain.

Disease prevention

Seizure prevention is timely treatment diseases that can cause pulmonary edema

Prevention of the development of an attack is the timely treatment of diseases that can cause pulmonary edema. It is also necessary to follow the safety rules when using toxic substances. Drug overdoses and alcohol abuse should be avoided.

It is impossible to completely exclude the development of pulmonary edema, since you cannot insure yourself against a generalized infection or injury, but you can try to reduce the risk of an attack.

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DOCTOR's consultations online

A patient: causes of pulmonary edema
Doctor: Most often, heart failure or shock

*******************
A patient: tell me, please. is it possible to determine without X-ray that liquid is gaining in the lungs
Doctor: It can be done by percussion, that is, by tapping the chest
A patient: my dad has diseased heart accurate diagnosis I can’t write because I’m not a doctor, he has shortness of breath today, during the examination, the cardiologist said that he is gaining fluid, how much is this true and what should I do?
Doctor: With heart disease, fluid can accumulate in the lungs. this indicates that the heart cannot function fully
Be sure to take all the drugs prescribed by the cardiologist, if you offer hospitalization, do not refuse - perhaps now your dad needs a change in therapy.
A patient: thank you very much!

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Pulmonary edema is quite serious condition, in which the transudate leaves the capillaries and enters the tissues of the lung and alveoli. This process leads to a decrease in the function of the alveoli, as well as a violation of normal gas exchange and oxygen starvation. Against this background, the composition of the blood changes significantly, the concentration of carbon dioxide in it increases. This pathological process is accompanied by severe depression of the central nervous system. The accumulation of excess interstitial fluid leads to edema. Pulmonary edema often causes death in humans different ages. The prognosis depends on the speed of providing first aid to the patient.

General description of pathology

The development of the primary mechanism of edema is very complex. The interstitium is made up of lymphatic vessels, connective tissue, blood vessels and interstitial fluid. The whole complex was opened by a special visceral pleura. An extensive branching of the hollow tubules makes up the lungs. The entire system of the respiratory organ is immersed in the interstitium. This substance is formed by the plasma that comes out of the blood vessels. After that, the plasma is absorbed again into the lymphatic vessels, which are connected to the vena cava. Through this complex process, the liquid supplies oxygen and the necessary nutritional components to the cells and removes metabolic products from them.

If the volume of the intercellular fluid or its outflow is disturbed, then pulmonary edema develops in such cases:

• If a significant increase in hydrostatic pressure in the vessels led to an increase in interstitial fluid. In this case, doctors talk about hydrostatic edema.
• If the fluid increase is due to excessive plasma filtration. In this case, we speak of membranous edema.

Pulmonary edema is a life-threatening condition that requires urgent medical care. This pathology is easier on the background of chronic diseases and most often occurs at night. This form of the disease responds well to drug treatment.

Pulmonary edema in heart disease develops rapidly, the patient's condition worsens very quickly and there is very little time for first aid.

With a lightning-fast form of cardiogenic edema, it is often impossible to save the patient.

The reasons

There are many reasons for the occurrence of pathology. Pulmonary edema cannot be considered an isolated disease. This is just a complication of some pathological process in the body. Cause acute edema lungs can be:

• Diseases that are accompanied by the ingress of toxins into the blood different nature. This is observed with sepsis and pneumonia, as well as with an overdose of certain drugs and drugs such as heroin and cocaine. Radiation damage to the lung tissue also leads to edema. Toxins greatly disrupt the structure of the membrane, due to this, its permeability increases significantly, and the liquid from small capillaries extends beyond the vessels.
• Pathologies of the heart in the stage of decompensation, which are accompanied by insufficiency of the left ventricle of the heart and a significant congestion in the pulmonary circulation. This is typical for a heart attack and severe heart defects.
• Diseases of the lungs that lead to congestion in the right circulation. These pathologies include bronchial asthma and emphysema.
• Thromboembolism of the pulmonary artery. This phenomenon occurs with a tendency to the appearance of blood clots. The risk group includes patients with hypertension and varicose veins veins. In such patients, a thrombus may form, which then detaches from the vascular wall and migrates throughout the body with the blood stream. Once in pulmonary artery clot clogs it. This leads to a strong increase in pressure in the vessel and the capillaries extending from it. In these vessels, the pressure of the liquid increases, which ultimately leads to the accumulation of excess fluid in the lungs.
• Pathologies that are accompanied by a decrease in the level of protein in the blood. These include severe illness liver and kidneys. In patients with cirrhosis of the liver or nephritis, oncotic pressure in the blood decreases, which leads to pulmonary edema.
• A large volume of fluid that is infused intravenously can also cause pulmonary edema. This occurs if forced diuresis is not performed simultaneously with the infusion. Due to this, the hydrostatic pressure of the blood increases, which leads to a serious condition.

In adults, pulmonary edema is diagnosed much more often than in children.. At the same time, the risk of developing such a pathology in an elderly person is much higher than in young people.

Athletes who train hard have big risk development of pulmonary edema. Some athletes experience swelling in the mild form, female athletes suffer from this disease more often than men.

Clinical picture

Symptoms of pulmonary edema most often appear suddenly and increase very rapidly. The symptomatology depends entirely on the stage of the disease. Clinical picture The interstitial and alveolar stages of pulmonary edema are very different.

According to the degree of progression of the main symptoms, the following forms of pulmonary edema are divided:

• Acute. Symptoms of alveolar edema appear several hours after signs of interstitial edema appear. This form of pathology is most often diagnosed in the adult population. The cause may be heart disease, which occurs due to severe stress or active physical activity. acute form pulmonary edema often accompanies myocardial infarction.
• Subacute. It lasts from 4 to 12 hours. Occurs due to fluid retention, mainly in renal or hepatic insufficiency. Happens when birth defect heart and anomalies large vessels. Often occurs when lung tissue is damaged by toxins or infections.
• Protracted. It may last a day or more. Happens when chronic insufficiency kidney, lung disease inflammatory nature and some systemic pathologies connective tissues.
• Lightning. Just a few minutes after the onset of the pathological process, a person dies. This pulmonary edema is the most common cause death from myocardial infarction and anaphylactic shock.

Against the background of chronic diseases, pulmonary edema often begins at night. This is due to the long horizontal position person. If a blood clot has become the cause of fluid accumulation, a person’s condition can worsen dramatically in different time days. Pulmonary edema in the elderly is particularly severe and often leads to serious consequences.

The main signs of pulmonary edema are quite specific and look like this:

• Severe shortness of breath is observed even in a state of complete rest. The patient's breathing is loud, bubbling, but quite frequent. You can hear how the patient breathes, even at a distance of several meters.
• Attacks of severe suffocation occur sharply. The patient feels an acute lack of air, this is especially noticeable in the supine position. In this case, a person takes a semi-sitting position of the body, in which it is easier for him to breathe.
• Lack of oxygen leads to severe pressing pain in the chest.
• The work of the heart is severely disturbed, markedly rapid heartbeat.
• Cough occurs with strong wheezing that can be heard even from a distance. When coughing, pink foam comes out profusely.
• On examination, the patient may notice abnormal pallor and cyanosis. skin. The person sweats profusely, and the sweat is cold and clammy. All these phenomena are associated with circulatory disorders.

In addition to these signs, there is confusion. A person first becomes overly excited, he is haunted by fears of death. As the disease progresses, arousal turns into lethargy and, as a result, a person may fall into a coma.

Mortality from pulmonary edema is very high. The prognosis depends on the form of edema and the speed with which the patient is treated. necessary assistance. At the first symptoms of the disease, an urgent need to call a doctor.

Diagnostics

Symptoms of pulmonary edema are very specific, but they do not always appear in a timely manner and in full, so diagnosis can be very difficult. If the patient is fully conscious, then the doctor listens to complaints and collects an anamnesis. Thanks to these data, it is possible to determine the root cause of such a pathology and try to eliminate it.

If the patient is unconscious, then a presumptive diagnosis is made on the basis of an examination of the person. According to the results of the examination, the doctor can suggest the reasons for this pathological condition.

When examining a patient, a specialist pays attention to the pallor and cyanosis of the skin. Too pulsating jugular veins and superficial, rapid breathing should alert the doctor.

The patient's pulse is weak and thready. The doctor may note the viscous cold sweat that covers the patient's body. When tapping the lung area, there is some dullness of sound above respiratory organs. This speaks of high density lung tissue. When listening to the lungs with a stethoscope, you can hear hard breathing accompanied by wheezing. The pressure in such a pathology can rise greatly.

To clarify the diagnosis, a number of laboratory tests are required:

• General blood test - with this analysis you can see if there is infectious process in the body.
• Biochemical blood test - helps to determine the causes of pulmonary edema. Based on the results of this analysis, it is easy to differentiate cardiac causes from other causes that were triggered by a decrease in protein in the blood. If, according to the results of such an analysis, it is clear that the level of urea and creatinine is increased, then we can talk about kidney pathology, which caused swelling of the respiratory organs.
• Blood clotting test. Indicates edema that has arisen due to thromboembolism of the pulmonary artery.

The patient must be assigned an analysis for research gas composition blood. If the analysis shows an increase carbon dioxide in the blood, pulmonary edema may be suspected.

Some instrumental methods diagnostics, these include:

• Determination of the level of oxygen saturation of the patient's blood. With edema, this figure does not exceed 90%.
• Measurement of central venous pressure.
• Electrocardiogram. Allows you to determine the violations of the heart.
• Ultrasound of the heart, helps to clarify the causes pathological changes that were detected on the ECG.

The patient must be sent for a chest x-ray. This study allows you to confirm or disprove the presence of fluid in the lungs. Pathology can be determined by unilateral or bilateral darkening, and if the edema is caused by a cardiac cause, then an enlarged shadow of the heart can be seen in the picture.

Sometimes narrow specialists are also involved to clarify the diagnosis and prescribe treatment. It can be a cardiologist and an infectious disease specialist.

Treatment

Treatment is carried out only in a hospital. If the patient's condition is too severe, then he is immediately placed in the intensive care unit.

If a person has signs of pulmonary edema, it is urgent to call an ambulance team. Even in the process of transportation, the patient is given first aid according to the approved protocol. Emergency care includes the following activities:

• The patient is comfortably placed half-sitting. In this position, breathing is greatly facilitated.
• According to the indications, oxygen therapy is carried out. If breathing is very difficult, then tracheal intubation is performed and then artificial ventilation is performed.
• AT clinical guidelines first aid is mandatory resorption of patients with nitroglycerin tablets.
• If necessary, the patient is injected with morphine, for pain relief.
• To reduce blood flow to the right side of the heart and prevent an increase in pressure in small system blood circulation on the legs of the patient are superimposed venous tourniquets. When applying bandages, you need to make sure that the pulse on the limbs is palpable.

Tourniquets can be applied for no more than 20 minutes. Remove the tourniquets after gradual loosening.

Further treatment of pulmonary edema is carried out in the intensive care unit or intensive care unit. Health workers around the clock monitor the pressure, as well as cardiac and respiratory activity in such patients. Medicines are given intravenously, most often into a subclavian vein into which a catheter is inserted. In the treatment of this pathology can be used medications such groups:

• Defoamers are often used for pulmonary edema. They consist of pure oxygen and ethyl alcohol vapor.
• If the pressure is elevated and there are signs of myocardial damage, nitroglycerin is prescribed.
• Diuretics or diuretics for rapid elimination excess fluid from the body.
• Drugs to increase heart contractions.
• If you're worried strong pain prescribe drugs based on morphine.
• If there are signs of thromboembolism, then anticoagulants are prescribed.
• If the work of the heart is too slow, they are prescribed.
• With symptoms of bronchospasm, hormonal agents are indicated.
• If some kind of infection has become the cause of the edema, then drugs with a large spectrum of action are prescribed.

In some cases, transfusion of blood or fresh frozen plasma is indicated. The duration of treatment for such a pathology can vary significantly. It depends on the severity of the patient's condition and the age of the patient.

Pulmonary edema is treated only in a hospital. Treatment at home is not carried out! Only emergency care can be provided to the patient at home.

Forecast

It is difficult to predict anything with pulmonary edema. The prognosis mainly depends on the cause that provoked the pathology. If the accumulation of fluid is not associated with heart disease, then the prognosis is most often good. The cardiogenic form is difficult to stop, therefore, in this case, mortality is higher. The consequences of cardiogenic pulmonary edema in the elderly are especially sad. Survival throughout the year is only 50%.

The most difficult prognosis for the toxic form of pathology. In this case, recovery is possible only with the introduction of a high dose of diuretics, although a lot depends on the endurance of the patient's body.

Sometimes warn this pathology it is quite possible and necessary, since the consequences of cardiogenic pulmonary edema are not always favorable. Prevention includes early detection and treatment of pathologies. Which can lead to excessive accumulation of fluid in the body. If there were danger signs pulmonary pathology, an ambulance should be called immediately.

Lungs - paired organ involved in gas exchange between the alveoli and blood. Internal structure lung is designed so as to accelerate the processes of gas exchange. This is facilitated by the alveoli - the constituent units of the body, similar to sacs with the thinnest walls. But such a structure also contributes to the rapid accumulation of fluid after damage to structural units - pulmonary edema, the causes and consequences of which require the attention of specialists.

Varieties of pulmonary edema

Pulmonary edema is the accumulation of fluid, not air, in the alveoli. The syndrome occurs suddenly, is characterized by dysfunction of gas exchange and the progression of hypoxia. The condition is accompanied by blue skin and suffocation.

The disease is differentiated depending on the causes of the development of the disorder.

• Membranous edema that develops after toxic exposure. The alveolar walls are affected, which contributes to the penetration of fluid from the capillaries.
• Hydrostatic edema resulting from diseases that increase intravascular pressure. The plasma enters the lungs, then into the alveoli.

The hydrostatic type of pathology is more often diagnosed. This is due to the high incidence of diseases of the cardiovascular system.

What causes pathology

The organ swells as a result dangerous diseases. Causes of pulmonary edema include:

• pneumonia;
• drug addiction;
• sepsis;
• severe diseases of the heart and blood vessels;
• chronic lung diseases;
• pulmonary embolism;
• diseases of the kidneys, liver;
• brain injury.

Pulmonary edema may develop as a result of an overdose medications, intravenous infusions, stay in a radioactively contaminated environment.

Signs of the disease

Pulmonary edema appears suddenly, usually at night (due to prolonged lying position). Signs of a pathological condition include:

• An attack of suffocation, increasing in the supine position. Develops due to oxygen starvation. The person has to sit down.
• The appearance of shortness of breath, not associated with physical activity.
• Compressive pain in the chest, palpitations. They appear as a result of oxygen deficiency.
• Superficial loud breathing due to irritation of the respiratory tract by carbon dioxide.
• slight cough that develops into coughing wheezing. Accompanied by the release of pink bronchial mucus.
• Cyanosis of the skin, along with the pallor of some areas.
• An increase in blood pressure, the pulse is weakly palpable.

The patient's mind is clouded. In the absence of medical assistance, loss of consciousness is possible.

Diagnostic methods

Diagnostic measures consist of several stages. Examination of the victim begins with the collection of anamnesis and external examination. When the patient is in a confused mind, it is required to evaluate Clinical signs in order to correctly establish the cause of pulmonary edema.

The doctor examines the patient's skin color, heart rate and pulse rate, respiratory activity. The specialist taps (percussion) and listens (auscultation) to the chest. It is required to determine the values ​​of blood pressure.

Then blood is taken for general and biochemical analysis. A coagulogram is prescribed to evaluate blood clotting.

If necessary, resort to instrumental diagnostics which includes:

• pulse oximetry - detection of oxygen saturation of the blood;
• the use of a phlebotonometer to assess performance central pressure in the veins;
• electrocardiography;
• ultrasound scan of the heart muscle;
• radiography.

AT severe cases can not do without catheterization of the artery of the lung. This surgical manipulation is indicated for patients with heart disease with pulmonary edema.

First Aid Methods

At the first manifestations of an unhealthy condition, you should immediately call an ambulance team. Because pulmonary edema dangerous phenomenon, the patient is provided with emergency assistance during transportation to medical institution. First aid includes:

• placing the victim in a half-sitting position;
• oxygen mask use and application artificial ventilation lungs;
• the imposition of tourniquets on the upper surface of the thigh, which excludes blood flow to the right atrium;
• taking Nitroglycerin;
• the introduction of analgesics of a narcotic nature, which has an analgesic effect;
• the use of diuretics.

Note! Medications for the treatment of pulmonary edema are administered through a catheterized vein.

Upon arrival at the hospital, the patient is admitted to the emergency room. In the first hours you need constant control for the main indicators: breathing, pressure, pulse. The choice of tactics and methods of treatment is carried out individually in each case, based on the cause of pulmonary edema. If pulmonary edema is not complicated by infection or pneumonia, therapy does not last more than 10 days.

The main consequences of pulmonary edema

Pulmonary edema leads to many complications. Reduced volume due to ischemia arterial blood supplied to the organs. Similar state occurs due to cardiogenic edema - left ventricular failure.

Most dangerous changes occur with organs that receive less oxygen: the heart muscle, brain, liver, adrenal glands, kidneys. Organ dysfunction leads to sharp decline contractility heart, which is a common cause of death.

Sequelae of pulmonary edema include.

• Atelectasis of the lungs, when there is no air in the alveoli, the lungs collapse. The disease causes displacement of some organs, impairs blood supply.

Note! If the cause of pulmonary edema is not eliminated, a relapse of the disease develops.

Toxic pulmonary edema is the most dangerous form pathology, can cause severe allergic reactions. Manifested as a result of poisoning with drugs, toxic compounds, gases. This condition often leads to complications such as pneumosclerosis, emphysema, pneumonia. Sometimes latent tuberculosis or infectious diseases become aggravated.

Video: Master class on emergency care for pulmonary edema

Death from pulmonary edema occurs in about half of the cases of its occurrence. Almost always, a fatal outcome is associated with untimely medical care.

The main causes of swelling are:

• heart failure;
• myocardial infarction (and many other heart pathologies);
• kidney or liver failure;
• bronchial asthma;
• toxic substances (drugs, drugs);
• pneumonia or pleurisy;
• sepsis;
• anaphylactic shock (death occurs in 90% of cases);
• massive administration of saline.

Most often, the etiology of the pathological process is acute left ventricular failure with overload of the right heart.

There are cardiogenic and non-cardiogenic types of pulmonary edema. In the last group, there are also toxic form defeat, which has its own characteristics. Toxic pulmonary edema can occur without a typical clinical picture. Because of this, it timely diagnosis happens to be difficult. In addition, with this type of swelling, there is a high probability re-development pathology. However, death from cardiogenic edema is more common, since two vital systems are affected simultaneously.

Forming a vicious circle

If a person has a cause of death - from pulmonary edema, then this may indicate a lack of emergency medical care or a belated diagnosis of the problem. However, even resuscitation does not always guarantee that the patient will survive.

The progression of swelling leads to the death of the patient due to the fact that a vicious circle is formed. Stages of its development:

• Provoking factor. It could be exercise stress, hypothermia, emotional stress and so on.
• Increased load on the left ventricle. Since the heart chamber is weakened by a long illness, it cannot cope with the load. Blood begins to stagnate in the lungs.
• Increased resistance in blood vessels. An excess of blood in the capillaries leads to the fact that fluid begins to seep through the membrane into lung tissue and alveoli.
• Hypoxia. Gas exchange in the lungs is disturbed, since the foam that appears there interferes with the transport of gases. The blood becomes less oxygenated.
• Reduction reduction. Due to insufficient oxygenation, an even greater weakening of the myocardium occurs. peripheral vessels are expanding. Return venous blood increases towards the heart. There is more blood in the lungs, and extravasation intensifies.

Independent way out of the formed vicious circle impossible. Therefore, without proper treatment, a person quickly overtakes death.

The rate of progression of the vicious circle will determine the time for which pulmonary edema will lead a person to death. With a heart attack, death can occur within a few minutes after the onset of the first symptoms. A chronic kidney failure exhausts the patient for several days. At the same time, there is a gradual increase in the symptoms of pathology.

How to recognize edema to prevent death?

Lung pathology most often develops during sleep. Its first signs will be:

• asthma attacks;
• growing cough;
• dyspnea;
• chest pain;
• blueness of fingertips and lips;
• increase in respiratory rate;
• acceleration and weakening of the pulse.

On auscultation, the doctor may hear dry wheezing. And blood pressure can vary, as it depends on the type of edema. In most cases, it is noted sharp rise type of hypertensive crisis. Sometimes it is unstable, but the most dangerous thing is if the tonometer shows its decrease.

Later on, there is an increase existing symptoms and the emergence of new ones. When interstitial pulmonary edema turns into alveolar edema, pinkish foam appears from the mouth. Cyanosis extends to the whole body. Breathing becomes even more frequent and bubbling. With a phonendoscope, you can listen to different-sized moist rales.

The main cause of death in this condition is acute ischemia internal organs. In addition, if the patient's blood pressure drops critically, then death comes due to cardiac arrest. To save the patient before the arrival of the ambulance, it is necessary to support the activity of the heart and breathing in every possible way.

How to avoid death?

The first action in the development of edema is to call an ambulance. While the doctors will get to the patient, he should be in a semi-sitting position. If respiratory or cardiac arrest is noted, it is urgent to proceed to resuscitation.

Having diagnosed the patient with pulmonary edema, the doctor emergency assistance in no case does not try to immediately transport him to the hospital. The chance that the patient will not die on the way is very low. First, the victim is given emergency treatment which includes:

• maintenance of vital functions;
• elimination of foam from the respiratory tract;
• decrease in the amount of fluid in the body;
• removal of pain syndrome;
• correction of electrolyte and acid balance.

However, it is possible to die from pulmonary edema even if all the necessary manipulations are performed. The body's response to medications can be unpredictable. For example, pathology can develop into a lightning-fast form and kill the patient in a few minutes. But conducting emergency care is a mandatory point of therapy that increases the chances of survival.

After performing the full range of manipulations, the patient is hospitalized, where they begin the main treatment. After getting rid of pulmonary edema, the risk of death is still not zero, as dangerous complications. The most unfavorable of them are hypoxic lesions of the brain and other internal organs. They are irreversible and cause death or disability.

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