Non-cardiogenic pulmonary edema, acute respiratory distress syndrome
Authors:
Hana Skalická; prof. MUDr. Jan Bělohlávek, Ph.D.
Authors‘ workplace:
II. interní klinika – klinika kardiologie a angiologie 1. LF UK a VFN, Praha
Published in:
Čas. Lék. čes. 2015; 154: 273-279
Category:
Review Article
Overview
Non-cardiogenic pulmonary edema is a clinical syndrome manifested by rapidly progressive respiratory distress leading, without therapy, to severe respiratory insufficiency and subsequent multiorgan failure. The pathophysiological causes are: the change in the pressure gradients in the pulmonary capillaries, the impaired membrane permeability of the alveolocapillary in the lungs, and impaired lymphatic drainage. Unlike in cardiogenic pulmonary edema, cardiac disease is not a cause, and there is no increase in wedge pressure (< 18 mm Hg). The aetiological base is diverse and includes more clinical pathological factors. The diagnosis and evaluation are usually very difficult due to the rapidly deteriorating clinical condition of the patients. A decisive, quick and comprehensive approach, using all available invasive and non-invasive methods is necessary. The basic steps of treatment are: the use of different types of ventilatory support in order to achieve adequate oxygenation, dealing with possible hemodynamic instability, and, when needed, other specific procedures. It is always important to keep in mind that this is a very serious condition with a high mortality rate. And there is a need for fast and efficient access to the best specialized clinic.
Keywords:
non-cardiogenic pulmonary edema – acute respiratory distress syndrome – protective ventilatory support – extracorporeal membrane oxygenation
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