Cough

Pulmonary edema due to pressure. Urgent medical care for pulmonary edema

Pathological increase volume of extravascular fluid in the lungs. For pulmonary edema in spaces outside the lungs blood vessels liquid collects.

In one type of edema, so-called cardiogenic pulmonary edema, fluid leakage is caused by an increase in pressure in the pulmonary veins and capillaries. As a complication of heart disease, pulmonary edema can become chronic, but there is also acute pulmonary edema, which develops quickly and can short time lead to the death of the patient.

Causes of pulmonary edema

Typically, pulmonary edema occurs due to failure of the left ventricle, the main chamber of the heart, resulting from heart disease. In certain heart conditions, more pressure is required to fill the left ventricle to ensure sufficient blood flow to all parts of the body.

Accordingly, the pressure in other chambers of the heart and in the pulmonary veins and capillaries increases. Gradually some of the blood sweats into the spaces between lung tissue. This prevents the expansion of the lungs and disrupts the gas exchange occurring in them.

In addition to heart disease, there are other factors that predispose to pulmonary edema:

Symptoms of pulmonary edema

Symptoms on initial stage Pulmonary edema reflects poor expansion of the lungs and the formation of transudate.

These include:

dyspnea;
sudden attacks respiratory distress after several hours of sleep;
difficulty breathing, which is relieved by sitting;
cough.

When examining the patient, a rapid pulse, rapid breathing, abnormal sounds when listening, swelling of the jugular veins, and abnormalities may be detected. normal tones hearts.

At severe swelling lungs, when the alveolar sacs and small airways fill with fluid, the patient’s condition worsens. Breathing quickens, becomes difficult, and the cough produces foamy sputum with traces of blood.

The pulse quickens, heart rhythms are disturbed, the skin becomes cold, clammy and acquires a bluish tint, and sweating increases. As the heart pumps less and less blood, blood pressure falls, the pulse becomes threadlike.

Descriptions of symptoms of pulmonary edema

Diagnosis of pulmonary edema

The diagnosis of pulmonary edema is made based on symptoms and physical examination, followed by testing of gases contained in the arterial blood, which usually shows a decrease in oxygen content. In this case, violations may also be detected acid-base balance and acid-base balance, as well as metabolic acidosis.

Chest X-rays usually reveal diffuse dimming in the lungs and often cardiac hypertrophy and excess fluid in the lungs. In some cases, catheterization is used for diagnostic purposes. pulmonary artery, which allows you to confirm left ventricular failure and exclude respiratory distress syndrome adults, whose symptoms are similar to those of pulmonary edema.

When examining a patient during an attack, attention is drawn to appearance patient, forced position in bed, characteristic behavior(excitement and fear).

Wheezing and noisy breathing can be heard in the distance.

When listening (auscultation) of the heart, pronounced tachycardia is noted (rapid heartbeat up to 150 beats per minute or more), bubbling breathing, heart sounds cannot be heard due to the “noise” in the chest.

The chest expands.

ECG (electrocardiogram) - during pulmonary edema, a heart rhythm disturbance is recorded on the cardiogram (from tachycardia to serious violations up to myocardial infarction).

Pulse oximetry (a method for determining blood saturation with oxygen) – in case of pulmonary edema it is determined sharp decline oxygen content in the blood up to 90%.

Treatment of pulmonary edema

Treatment of pulmonary edema should be carried out in a department (ward) intensive care. Treatment tactics directly depend on indicators of consciousness, heart rate, blood pressure and in each individual case may differ radically.

The general principles of treatment are:

Reduced excitability of the respiratory center.
Promotion contractility hearts.
Unloading of the pulmonary circulation.
Oxygen therapy (saturation of blood with oxygen).
Use of sedative (calming) drugs.

The patient is given a semi-sitting position in bed, with his legs lowered to the floor to reduce the return of blood to the heart.

Oxygen therapy (saturation of the blood with oxygen by inhaling it) is carried out by connecting the patient to a machine supplying oxygen or oxygen with alcohol vapor (to saturate the blood with oxygen and reduce foaming).

It should be borne in mind that against the background of pulmonary edema, blood pressure can either decrease (up to shock) or increase (up to hypertensive crisis), the heart rhythm may be disturbed. Treatment must be carried out under the control of the patient's condition and constant measurement of blood pressure.

Questions and answers on the topic "Pulmonary edema"

Question:Hello! What are the complications of pulmonary edema?

Answer: Most complications of pulmonary edema are associated with its underlying cause. More specifically, pulmonary edema can threaten severe hypoxia and, as a consequence, the occurrence of oxygen starvation of all organs and systems, including such vital ones as the brain, with all the ensuing consequences.

Question:Tell me, is instant pulmonary edema with a fatal outcome possible at high temperatures? Just a man with high temperature went to work, something bad happened to him there. I ended up in intensive care and within 5 days burned out from instant pulmonary edema. Was there really nothing that could have been done?

Answer: Unfortunately, with influenza, especially H1N1, a fulminant course of the disease is possible, which, despite the active and full treatment, can lead to pulmonary edema and death.

Question:My father is 52 years old and suffers from second degree diabetes. On tablets. The sugar level is always normal, 3-5 units. At the birthday party after apparently large quantity Alcohol has been making me sick all day, and it’s very hard to breathe, essentially suffocating. All this happened from early morning until evening. In the evening it got better, but when I went to bed I started to choke again. At night they dialed 03. They called an ambulance, they said it was pulmonary edema, but there was no heart attack. The cardiogram is bad. Is all this dangerous for him?

Answer: Yes, unfortunately, it is really dangerous. With concomitant pathology - diabetes mellitus, any pathological conditions are much more difficult to treat. With timely and qualified assistance, even with this condition, the prognosis can be positive.

Question:How quickly do the lungs recover after swelling?

Answer: This primarily depends on what caused the pulmonary edema. And on the methods by which they were restored. For example, mild mountain pulmonary edema does not make itself felt within a day or two after descending to the plain.

Question:What causes pulmonary edema? What can be done to prevent it from happening or to prevent it?

Answer: Pulmonary edema is the accumulation of aqueous fluid in the pulmonary vesicles (alveoli) and in the lung tissues. This is not independent disease, but a serious complication of other diseases. It occurs as a result of stagnation of blood in the lungs caused by heart failure due to heart defects, hypertension, myocardial infarction, acute inflammation kidneys, uremia. Edema can also occur due to inflammatory or toxic damage pulmonary vessels, as well as when the patient lies in bed for a long time.

Question:Tell us why it’s swelling there And why? Is it the bronchi that swell or is there something else called edema?

Answer: Pulmonary edema occurs due to an excess of blood in the lungs, when the pressure in the pulmonary capillaries is too high, fluid from them leaks into the alveoli and this disrupts gas exchange. Occurs with left ventricular heart failure, pulmonary embolism, with increased permeability of the pulmonary vessels due to some reason, for example, sepsis, chest trauma, pancreatitis, pneumonia, reflux of gastric contents, water and other liquids into the respiratory tract, inhalation of toxic gases (ozone, chlorine, phosgene), smoke, mercury vapor, water and other vapors, in case of renal failure...

In the formation of pulmonary edema, the process of fluid release from the capillaries into the lung tissue is important. Moreover, this content is called transudate. Gas exchange in the lungs is disrupted, and the pulmonary organs become denser.

Oxygen starvation is of primary importance lung tissue. This requires urgent medical attention. There are several types pulmonary edema. The first type of lung pathology is associated with cardiac disorders.

That is why cardiogenic pulmonary edema is isolated. The following type of pulmonary edema is also appropriate. Another type of disease is respiratory pulmonary edema. Moreover this type Pulmonary edema depends on various factors.

And finally, the third type of pulmonary edema is called mixed. That is, many factors are directly involved in the pathological process. IN in this case diseases not associated with the first and second types of edema.

What is it?

Pulmonary edema is a pathological process that results in an increase and decrease in pressure in the pulmonary capillaries. The course of the disease varies. Some variants of the course of the disease are important:

lightning current;
acute course;
subacute;
lingering.

Fulminant pulmonary edema – rapid development pathological process, which is accompanied by tissue damage and detection of transudate. Fulminant pulmonary edema is always fatal. Acute pulmonary edema is a rapid increase in symptoms, in which medical treatment is of great importance. emergency care.

The subacute course of pulmonary edema is the variability of the symptoms of the disease. Moreover, the disease may progress clinical symptoms. Or vice versa – subsiding of symptoms.

Prolonged pulmonary edema is a long-term disease process. Moreover, it can occur hidden. In some cases there is no clear clinical picture. What is an unfavorable factor in diagnosis?

Reasons

The etiological signs of pulmonary edema are varied. Great value has the fact of existence various diseases. Including diseases of the cardiovascular system. These include the following pathologies:

cardiosclerosis;
acute myocardial infarction;
arrhythmias;
heart failure.

Pulmonary edema can also be caused by diseases related to the respiratory system. Mostly bronchial asthma, tuberculosis, pneumonia. And only if there is severe course of these diseases. For example, in the absence of proper drug therapy.

Pulmonary edema can also be caused by infectious diseases. For example, influenza, measles, diphtheria, whooping cough and many others. Most serious illnesses kidneys can cause pulmonary edema.

Often, pulmonary edema can be caused by intoxications of the body. Moreover, intoxication of an alcoholic nature and associated with taking medicines.

Symptoms

In the symptoms of pulmonary edema, the periods preceding the disease are important. These include certain conditions of the patient in which his well-being improves. For example, the patient may feel some weakness, dizziness,...

Sometimes a cough and chest tightness may occur. Moreover, these states are preceded by a certain period of time. This period time is usually characterized by a short period, from several minutes to several hours.

Clinical signs of pulmonary edema usually appear at night, sometimes in the morning. There are physical strains, and of an intense nature. Increased psycho-emotional stress also plays a role. Rarely, hypothermia can affect the condition, usually in the presence of other diseases.

TO general symptoms diseases include cyanosis of the lips, cold sweat, increased blood pressure. Tachycardia matters. In a more severe stage of pulmonary edema, the following is detected:

respiratory failure;
dyspnea;
swelling of the veins of the neck.

Foam often comes out of the patient's mouth. Pulmonary edema is accompanied by various complications. The patient is also characterized by lethargy and confusion. Sometimes it can develop.

Death occurs due to pulmonary edema as a result of asphyxia. That is, direct suffocation of the patient. This is preceded by a state of decreased blood pressure and shallow breathing.

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Diagnostics

In diagnosing the disease, anamnesis is important. History taking includes examination possible reasons diseases. Including the presence of certain clinical signs. Diagnostics also uses the method of objective examination of the patient, including subjective signs.

Diagnosis of pulmonary edema includes laboratory, biochemical, and instrumental studies. To the most necessary methods Diagnosis of pulmonary edema includes:

blood gas examination;
electrocardiography;
ultrasound diagnostics of the heart;
X-ray of the chest organs.

Blood gas testing can reveal gas exchange disorders in the lungs. Moreover, this change to initial stage characterized a certain sign. Subsequently, the state of impaired gas exchange noticeably worsens.

Electrocardiography reveals pathology of the left ventricle. Moreover, this pathology is characterized by an increase in the size of the left ventricle. Arrhythmias are often detected. On ultrasound diagnostics a decrease in left ventricular contractility is detected.

Chest X-ray allows for the most accurate diagnosis. The boundaries of the heart expand. This allows you to detect pulmonary edema. Which indicates the most severe pathology.

In diagnosing pulmonary edema, consultation with some specialists is important. Moreover, this depends on the presence of the underlying pathology. In this case, the consultation involves an examination by a cardiologist, pulmonologist, or therapist.

Prevention

Pulmonary edema can be prevented. It depends on the treatment of the underlying disease. Moreover, it is necessary to avoid the influence of toxic factors. For example, exception overuse body.

It is necessary to adhere to certain measures in prevention. First of all, avoid complications infectious diseases. If an infection enters the human body, it is important to start immediately drug therapy. Since the infectious process can develop into a chronic stage.

It is known that chronic stage the disease lasts quite a long time. Infections and viruses can be present in the human body and cause adverse consequences. Including affecting other organs and systems.

The use of medications is also important. For example, if there is allergic reaction It is important to discontinue the drug. Since the reaction caused by an allergy can be extremely unfavorable. Such reactions include anaphylactic shock.

As a result of anaphylactic shock, pulmonary edema occurs. A difficult pregnancy is also of great importance in the prevention of the disease. For example, in case of eclampsia in pregnant women. If this condition is not eliminated, pulmonary edema develops.

Cardiovascular pathology plays a decisive role. For example, severe conditions due to myocardial infarction. That is why great importance is given to these pathologies, they are treated in a timely manner and timely diagnosis is carried out.

Treatment

In case of pulmonary edema, immediate medical attention must be provided. To do this, enter the necessary medical supplies. TO medicines include:

defoamers;
morphine;
heparin;
lasix;
nitroglycerine.

These drugs allow you to stop the most severe symptoms pulmonary edema. Narcotic drugs suppress painful sensations. Diuretics eliminate hypertension. Nitroglycerin relieves angina.

If pulmonary edema is accompanied by an increase in blood pressure, then it is advisable to take the following method:

sit the patient down with his legs down;
administer pentamin intravenously;
administer clonidine in saline solution intravenously.

If arterial hypertension most pronounced, the patient is provided with the following assistance:

laid with the head end raised;
Dopamine is injected slowly intravenously;
if pulmonary edema intensifies, then nitroglycerin is prescribed intravenously.

In the future, the patient must be hospitalized in intensive care unit. Or to the intensive care ward of the cardiology department. Transportation of the patient is of great importance.

Transportation, strictly lying on a stretcher. Definitely with a raised head end. Or sitting on a stretcher using oxygen therapy.

In adults

Pulmonary edema in adults occurs against the background of various diseases. Pulmonary edema occurs equally in both men and women. And in different age categories. Pulmonary edema in the elderly has a more serious course.

The disease in women is often associated with a difficult pregnancy. Especially in the presence of attacks of eclampsia. Pulmonary edema in women is also associated with ovarian pathology. Especially when they are stimulated to an increased degree.

It is known that the ovaries have a hormonal nature of the disease. Therefore, these disorders often cause a serious malfunction in the body system. The causes of pulmonary edema in men may be cardiac pathology. Including the development of myocardial infarction.

Men are more likely to have heart disease. Moreover, against the background of alcohol intoxication, the disease worsens. Therefore, pulmonary edema occurs. These diseases play a role in the etiology of the disease in adults:

brain disorders;
surgical interventions;
burns.

Often the cause of pulmonary edema in adults is nicotine poisoning. Therefore it is necessary to highlight this reason. Oddly enough bad habits can cause extensive intoxication of the body.

Some septic conditions also cause pulmonary edema. It is necessary to prevent suppurative processes. Often, sepsis can be a secondary factor. Therefore, it is advisable for adults to conduct research on various organs. Including increasing the body's reactivity.

In children

Pulmonary edema in children most often develops during the neonatal period. This pathology associated with severe hypoxia. Hypoxia is caused by various disorders:

with toxicosis of pregnant women;
infectious lesion;
viral infection.

Moreover, the factor of prematurity plays a role. Premature babies have a number of pathologies. Unlike children born at term, premature children are more likely to negative influence external factors. Premature babies are at risk for pulmonary edema.

It is not for nothing that premature babies are monitored. Treatment methods are used, the ward of the premature baby matters. It creates appropriate conditions.

In older age groups, pulmonary edema can develop due to acute laryngitis and the presence of adenoids. Aspiration of foreign bodies into preschool age caused by the child's lack of awareness. A child may swallow part of the toy, resulting in asphyxia.

If proper care is not provided to the child, the condition is complicated by the presence of pulmonary edema. That's why therapeutic measures must be done immediately. Teen suicide also causes pulmonary edema.

It is known that adolescent suicide is the most pressing phenomenon in modern world. Hanging causes immediate pulmonary edema. Subsequently, death occurs.

If a child has pulmonary edema, parents should urgently call ambulance. Delivery methods first aid identical to methods of providing care to adults. Therefore, urgent action should be taken necessary measures. However, without qualified specialist medical therapy is ineffective!

Forecast

With pulmonary edema, the prognosis is most often unfavorable. This is due to the course of the disease. And also with the presence of an underlying pathology. Often the prognosis is worst.

It should be noted that the prognosis worsens with acute course pulmonary edema. In the presence of anaphylactic shock, the prognosis is also unfavorable. The earlier the disease is detected, the more timely treatment should be carried out.

Treatment of the underlying disease contributes to a favorable prognosis. Also timely diagnosis at the initial stage of the disease contributes to a favorable prognosis. This is the most necessary prevention complications.

Exodus

Death in most cases is associated with anaphylactic shock. The acute stage of pulmonary edema also has unfavorable outcomes. Mortality from pulmonary edema is high.

Recovery rarely occurs unless the underlying disease is eliminated. If you manage to eliminate the underlying pathology, then you can achieve full recovery. Therefore, treat the underlying disease!

Complications often occur after pulmonary edema. In this case, the following consequences of pulmonary edema are distinguished:

congestive pneumonia;
pneumosclerosis.

Lifespan

In order to avoid reoccurrence pulmonary edema must be followed therapeutic therapy underlying disease. This not only increases life expectancy, but also significantly improves its quality. Life expectancy also depends on the condition of the human body.

If the condition is weakened due to the presence of infections, then appropriate measures are taken. Pulmonary edema often contributes to the development of complications. This reduces life expectancy.

In most cases, the patient's life is shortened if there is anaphylactic reactions. In addition, if pulmonary edema is at acute stage course of the disease. Therefore, treat the disease when it manifests itself. initial signs development of this condition!

- this is one of the most dangerous conditions person. To understand its essence, it is worth saying a few words about the lungs themselves. They are a complex of tubes similar to an extensive network. Some tubes are hollow, others seem to be immersed in fabric. This also includes blood vessels, connective fibers, and intercellular fluid. Collectively this is called interstitium. So, during pulmonary edema, the fluid content contained directly in the interstitium exceeds the norm.

Extravascular fluid tends to accumulate in the lungs, which can even lead to fatal outcome. That is why, at the first signs of edema, measures should be taken, because if the edema is lightning fast, then death will occur within a couple of minutes. There is also acute edema, which is characterized by a two- or three-hour development. And also protracted - it can last from several hours to several days.

Reasons

Almost always, the causes of pulmonary edema are either pathology or an unbearable load on the heart (in this case, the edema is called cardiogenic). Because of this, stagnation forms in the pulmonary circulation, and the vessels of the lungs begin to collapse. Diseases such as diastolic and systolic dysfunction (the so-called types of heart failure) or left ventricular dysfunction can provoke edema. The cause of toxic edema is damage to the alveolo-capillary membranes by relevant substances (for example, alcohol or arsenic). Any products causing allergies, can cause allergic swelling.

In addition, the cause of edema can be heart disease, myocardial infarction - in short, diseases associated with cardiovascular system; tuberculosis, chronic bronchitis, pneumonia – lung diseases; flu, acute laryngitis, measles are diseases that are characterized by intoxication; as well as poisoning, frequent heartburn, uncontrolled use of medications and even getting water into the lungs, for example, while swimming.

Symptoms

Signs of pulmonary edema can be different and they also develop differently, it depends on what type of edema a person has - prolonged or rapid. If swelling develops slowly, the first thing that appears is shortness of breath. Moreover, there are no reasons for this - rapid breathing torments both during exercise and even in a state of long rest. Dizziness often begins to bother you, and if at first these were fleeting attacks, then over time they become more frequent and longer. And then comes drowsiness, fatigue, and the person feels overwhelmed. These are the first symptoms of pulmonary edema and should not be ignored.

Rapid swelling is characterized by its rapid development, more often it occurs at night. A person suddenly wakes up because he begins to feel as if he is being strangled. Puffing then whooping cough, which intensifies with excitement. Sputum begins to be coughed up, which gradually becomes more liquid. Wheezing or even whistling may be heard from the chest. The face usually turns pale, partly due to panic. The attack continues for 25 minutes. With such symptoms of pulmonary edema, help is needed immediately.

Diagnostics

Usually, the first warning signs can be identified using a chest x-ray. If there is no threat, then the person’s lungs will have normal look(dark areas). If there is any risk, then the image will show bright fields that are not typical for healthy lungs. If the doctor sees cloudiness, then a more in-depth diagnosis of pulmonary edema is needed. You should be observed in the clinic - perhaps the pulmonary alveoli are filled with fluid. In these cases, it is carried out additional tests or even measuring pressure in the pulmonary vessels. The latter process, although not very pleasant - a tube is inserted into noticeable veins in the neck - however, it allows you to accurately identify the causes of swelling.

First aid

Everyone must be able to provide first aid for pulmonary edema. Since an attack usually begins when the patient is lying down, the first thing to do is to help him take a semi-sitting position. A nitroglycerin tablet is placed under the tongue and needs to be dissolved. If it doesn’t help, then you can give a second one, but not earlier than 10 minutes later (in total, no more than six tablets per day). In short, the first thing you need to do is get rid of suffocation.

If the pressure is high, then top part A tourniquet can be applied to the thighs (they must be removed after 20 minutes!). This is necessary in order to reduce blood flow to the right side of the heart and, ultimately, prevent a surge in pressure in the pulmonary circulation that may occur in the future. Inhalation of alcohol vapor will also help: for children use thirty percent alcohol, for adults - seventy percent.

Treatment

After the patient is taken to the hospital (often this is the intensive care unit), emergency care comes in the form of bloodletting, the administration of diuretics, and the use of an oxygen mask. Usually after such measures the condition stabilizes and begins full treatment pulmonary edema. Now we need to eliminate not the symptoms, but the very cause of the swelling. Doctors constantly monitor breathing, pulse, and blood pressure. But first of all, the nature of the edema is determined. If it is cardiogenic, then medications are prescribed that eliminate heart failure. In cases where this is not enough, diuretics may be prescribed.

If pulmonary edema is caused by any infection, then the patient will have to undergo antibacterial and antiviral therapy. Anti-anxiety medications are often prescribed. They are needed for successful fight with stress. This is not only a plus for state of mind, but also physical benefits - vascular spasms are reduced, shortness of breath is reduced, the penetration of tissue fluid through the capillary-alveolar membrane returns to normal.

It is important to start treatment on time, because the slightest delay can lead to oxygen starvation, including brain starvation - vital important body.

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

Lung structure It is a thin-walled pouch 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 into the alveoli (alveolar pulmonary edema).

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

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

The causes of pulmonary edema, in most cases, are associated with pathology and acute overload of the heart, in this 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 by toxic substances; such edema is called toxic. Allergic pulmonary edema is caused by products of an allergic reaction.

Pulmonary edema can be caused the following diseases and states:

Diseases of the cardiovascular system (myocardial infarction, post-infarction cardiosclerosis, atherosclerotic cardiosclerosis, heart disease, aortic aneurysm, and so on);
Lung diseases (pneumosclerosis, chronic bronchitis, lung tumors, pulmonary tuberculosis, pneumonia, fungal infections 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, foreign body into the respiratory tract, suffocation with vomit);
Uncontrolled use of medications, massive heartburn, alcohol intoxication, poisoning, drug intoxication, finding long time on the device artificial respiration can also provoke the development of pulmonary edema.

Forms of the disease

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

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

Acute pulmonary edema develops within 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 efforts 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. Initial symptoms of pulmonary edema include frequent coughing, increasing wheezing, and changes in complexion. Then the patient begins to feel severe suffocation, tightness in the chest, pressing pain, while breathing quickens and bubbling wheezing becomes audible in the distance.

During a cough, foamy pink sputum begins to come out, with in serious condition foam begins to come out of the nose. It becomes difficult for the patient to inhale and exhale air, bluish skin appears, neck veins swell and cold sweat appears. The pulse increases sharply to 140-160 beats per minute. During an attack, damage to the upper respiratory tract, a coma and death may occur.

If the patient develops symptoms of pulmonary edema, you should immediately call an ambulance.

Diagnosis of the disease

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

Diagnosis of pulmonary edema is usually made using chest x-ray. At in good condition the lungs appear as dark areas in the image, and with pulmonary edema, an atypical clearing of the pulmonary fields is observed. In severe cases, significant clouding appears on the image, which indicates that the pulmonary alveoli are filled with fluid.

Observation is necessary to determine the cause of the disease clinical picture patient. For this purpose, a general examination is carried out, anamnesis data is studied and general examination. Also, to make a diagnosis, an analysis is carried out for the concentration in the blood plasma of both N-terminal propeptide and type B natriuretic peptide. difficult situations direct pressure measurement may be necessary pulmonary vessels. With such a study in large veins A thin long tube is inserted into the chest or neck - a 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 the person in a state of attack is lying or sitting;
Existing fluid should be aspirated from the upper respiratory tract;
With high blood pressure, bloodletting is performed: 100-200 milliliters of blood are released for children, and 200-300 milliliters for adults;
A tourniquet is applied to the legs for 30-60 minutes;
Alcohol vapor is inhaled: children are inhaled with 30% alcohol, and adults - with 70% alcohol;
2 milliliters of a 20% camphor solution is administered subcutaneously;
The airways are enriched with oxygen using an oxygen cushion.

Treatment of pulmonary edema

In the hospital, emergency care consists of performing bloodletting, administering cardiac glycosides, Lasix or Novurit and continuing oxygen therapy

In a hospital, emergency care consists of performing bloodletting, administering cardiac glycosides, Lasix or Novurit, and continuing 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, normalizing heart function and improving the metabolic process in the myocardium.

Also, treatment of pulmonary edema is aimed at carrying out measures that promote compaction of capillary-alveolar membranes. During treatment, it is often prescribed sedatives to remove the patient from stressful situation and normalizing it psychological state. Such drugs not only improve emotional background 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. 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 can completely eliminate swelling.

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 the vital organ - the brain.

Disease prevention

Preventing the development of an attack is timely treatment diseases that can cause pulmonary edema

Preventing the development of an attack consists of timely treatment of diseases that can cause pulmonary edema. It is also necessary to follow safety rules when using toxic substances. Overdoses of medications 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 consultations online

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

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Patient: Tell me, please. Is it possible to determine without X-ray that fluid is accumulating in the lungs?
Doctor: You can use percussion, that is, tapping the chest
Patient: at my dad's sick heart accurate diagnosis I can’t write because I’m not a doctor. He has shortness of breath. Today, during an examination, the cardiologist said that he was gaining fluid, how true is this 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 medications prescribed by the cardiologist; if he suggests hospitalization, do not refuse - perhaps now your dad needs a change in therapy.
Patient: Thanks a lot!

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Pulmonary edema is pathological condition, which occurs suddenly and is accompanied by the leakage of fluid from the capillaries into the interstitial tissue of the lungs and alveoli. This pathology leads to disruption of gas exchange and oxygen starvation tissues and organs. It manifests itself as severe suffocation, cough (initially dry, and then with copious amounts pink frothy sputum), shortness of breath and cyanosis skin. If emergency assistance is not provided, it can lead to death.

Pulmonary edema may begin with difficulty breathing and chest pain.

Pulmonary edema can be provoked by physical activity, a transition of the body from a vertical to a horizontal position, or psycho-emotional arousal. In some cases, it may begin with precursors: increased breathing, increasing shortness of breath and coughing with moist wheezing.

According to the speed of development, pulmonary edema can be:

acute: develops within 2-3 hours;
lightning: the death of the patient is caused by suffocation within a few minutes;
protracted: develops over several hours or days.

At the beginning of an attack in a patient, fluid accumulates in the interstitial tissue of the lungs: interstitial pulmonary edema. This condition accompanied by the following symptoms:

pain or pressure in the chest;
increased breathing;
frequent coughing without sputum production;
bronchospasm may occur;
increasing with difficulty inhaling and exhaling;
feeling of lack of air;
tachycardia;
increased blood pressure;
cold clammy sweat;
severe pallor;
increasing weakness;
increased sweating;
anxiety.

The patient strives to take a forced position: he sits on the bed, dangling his legs, and rests on his outstretched arms. When fluid passes into the alveoli and the onset of alveolar edema mild condition the patient deteriorates significantly:

shortness of breath increases, breathing becomes bubbling;
suffocation increases;
the skin takes on a bluish-gray tint;
cough gets worse;
frothy pink sputum appears;
the veins in the neck swell;
increases (up to 140-160 beats per minute);
the pulse becomes weak and thready;
possible decrease in blood pressure;
the patient experiences fear of death;
confusion appears;
in the absence of adequate assistance, the patient may fall into a coma.

During an attack, the integrity of the respiratory tract may be compromised and death may occur.

After stopping an attack of pulmonary edema, the patient may develop severe complications:

pneumonia and bronchitis (due to secondary infection);
cerebrovascular accidents;
segmental atelectasis;
pneumofibrosis;
ischemic damage to organs and systems.

Pre-hospital emergency care

At the first sign of swelling lung patient or those around him should call an ambulance.
Place the patient in a semi-sitting or sitting position with legs down.
Ensure sufficient inflow fresh air, open windows and vents, remove clothing that restricts breathing from the patient.
Constantly monitor your breathing and pulse.
Measure (if possible) blood pressure.
Place the patient's feet in hot water.
Apply a tourniquet to the thigh for 30-50 minutes, then apply it to the other thigh.
Inhale alcohol vapor (for adults 96%, for children 30%).
At a pressure not lower than 90 mm. Hg Art. Give the patient a Nitroglycerin tablet under the tongue.
Give the patient a Furosemide (Lasix) tablet.

Emergency medical care

After the ambulance arrives, the patient is given intravenous narcotic analgesic(Morphine, Promedol), Lasix and Nitroglycerin. During transportation to the hospital, the following activities are performed:

Emergency care and hospital treatment

Treatment of pulmonary edema in the emergency department is carried out under constant monitoring of blood pressure, pulse and respiratory rate. Most drugs are administered through a catheter into the subclavian vein. The treatment regimen is determined for each patient individually depending on the causes of pulmonary edema.

The treatment package may include the following drugs and measures:

During treatment of pulmonary edema, the patient must adhere to a restricted diet table salt, liquids and fats, completely eliminate respiratory and physical activity. After the course of treatment of the underlying disease, the patient must be under outpatient observation doctor