Pulmonary Edema

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Pulmonary Edema
Pulmonary Edema
Video: Pulmonary Edema
Video: Pulmonary Edema - causes, symptoms, diagnosis, treatment, pathology 2023, February
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Pulmonary edema

In pulmonary edema, fluid accumulates in the lung tissue and / or the alveoli (alveoli of the lungs). Pulmonary edema can be acute or chronic.

Interstitial edema is when it occurs between the cells but has not yet entered the “air space” of the lungs - the distance between the air space and the blood increases and gas exchange becomes more difficult. If the fluid passes into the alveoli, it is an alveolar edema - the air space becomes smaller!

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Cause & symptoms

In the lungs, oxygen is absorbed and carbon dioxide is released; the release of carbon dioxide also regulates the internal environment - the pH value. In order for the gas exchange to take place, close contact between the air space (alveoli, alveoli) and the blood (capillaries) is necessary. This can only be achieved by keeping the distance between air and blood very small.

Particularly with alveolar edema, enough oxygen can no longer be absorbed. There is a lack of oxygen, little exhalation of carbon dioxide (CO 2) and a drop in the pH value in the blood. As a result, there is a risk of life-threatening conditions that require urgent treatment (lack of oxygen, acidosis).

The accumulation of fluid in the lungs can occur, for example, in:

  • Backwater”because the removal of blood from the lungs is reduced

    Heart disease (e.g. pump failure of the left ventricle - left heart failure)

  • Excess water in the capillaries,

    • Kidney failure,
    • Malnutrition,
    • Cirrhosis of the liver, liver failure,
  • Damage to the wall of capillaries and alveoli,

    • Poisoning through inhalation of gases, vapors (acids, chlorine gas), smoke gas inhalation,
    • Shock (blood loss, allergic, infectious),
    • allergic reactions,
    • Infections, especially blood poisoning (sepsis),
    • Altitude sickness (staying in mountains above 4,000 meters).

Acute pulmonary edema can manifest itself through the following symptoms:

  • Shallow breathing, rapid breathing,
  • Restlessness, fear,
  • To cough,
  • frothy, possibly bloody expectoration,
  • increasing shortness of breath (even when resting),
  • Breathing noises (rattling noises),
  • Bluing of the lips / skin.

Note Severe shortness of breath is always an emergency! In the case of accelerated breathing, increased breathing, breathing noises (e.g. rattling), coughing fits with foamy sputum and bluish discoloration of the lips / skin, cold sweat and fear of death, you must act quickly, dial the emergency number (112 or 144!) Immediately and call first aid. Measures are taken. For information on first aid measures, see Emergency: Difficulty breathing in adults.

Inhaling gases can also cause an emergency. For information on symptoms and first aid in the event of poisoning, see

  • Poisoning: gases
  • as well as poisoning in adults.

diagnosis

In addition to the symptoms already mentioned, other findings are important for the doctor. Physical examination, x-rays of the lungs and laboratory values ​​(blood gas values) provide clues. In order to determine the cause of the edema, various tests are also carried out, e.g. EKG, ultrasound of the heart (echocardiography), laboratory values ​​/ blood values ​​(e.g. to check kidney function).

therapy

Pulmonary edema is a life-threatening condition and intensive medical treatment is often necessary. In the ambulance or in the hospital, measures are taken to stabilize the circulatory and lung function of the person affected. Treatment of pulmonary edema is also based on the cause. Treatment options for pulmonary edema, depending on the cause and severity, include:

  • Drug treatment (diuretics, nitrates, morphine, ACE inhibitors, heparin, etc.) - certain drugs (e.g. vasodilators) can also be administered intravenously,
  • Bed rest with the upper body elevated and legs lower,
  • Oxygen therapy using a mask,
  • mechanical positive pressure ventilation and much more

Further information on the treatment of the underlying diseases can be found under the individual disease (e.g. heart failure, liver cirrhosis, allergies, pulmonary embolism, etc.)

Whom can I ask?

In the event of severe shortness of breath (increased breathing, accelerated breathing, coughing fits with foamy sputum, fear and bluish discoloration of the lips / skin) or loss of consciousness, the ambulance or the European emergency number must be called immediately (emergency number 144 or 112)!

Depending on the cause of the pulmonary edema, doctors from various disciplines (e.g. for general medicine, especially in primary care, intensive care, internal medicine, cardiology, pulmonary medicine, etc.) are involved in the diagnosis and therapy process.

How are the costs going to be covered?

The costs for diagnosis and therapy are usually covered by the social security authorities.

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