Šedý J. Neurogenic pulmonary oedema
Authors:
Jiří Šedý
Authors‘ workplace:
Ústav experimentální medicíny AV ČR, v. v. i., Praha
Published in:
Čas. Lék. čes. 2011; 150: 147-155
Category:
Review Article
Overview
Neurogenic pulmonary oedema is a complication of severe central nervous system injury. The centre of neurogenic pulmonary oedema is assumed to be a group of dorsal ventrolateral medulla nuclei, which are activated by a combination of afferent pathway hyperactivity and a sudden increase of intracranial pressure. The sympathetic system plays a crucial role in the pathogenesis of neurogenic pulmonary oedema by activating a rapid cascade of processes, leading to interstitial and intraalveolar oedema, together with important haemorrhage. For the diagnosis of neurogenic pulmonary oedema, physical examination and chest X-ray are crucial. The differential diagnosis is not easy, but the chances of proper diagnosis are increased when the relation between the central nervous system injury and the pulmonary problems is considered. Targeted curative treatment of neurogenic pulmonary oedema does not exist yet; thus, the treatment options are mainly supportive and symptomatic. The most important ones are continuous patient monitoring, posture and ventilation and oxygenation support. There are several experimental models that can be used for studying the etiopathogenesis or treatment of neurogenic pulmonary oedema. The main goal of experimental studies is to elucidate a preventive and therapeutic approach that is able to prevent or treat neurogenic pulmonary oedema. In this context, the most promising agent is atropine.
Key words:
neurogenic pulmonary oedema, brain injury, spinal cord injury, sympathetic nervous system.
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