Noncardiogenic Pulmonary Edema
Noncardiogenic Pulmonary Edema is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Noncardiogenic pulmonary edema (NCPE) occurs secondary to accumulation of excess fluid and protein into the alveoli from factors other than increased pulmonary capillary pressure >18 mm Hg
- Permeability pulmonary edema:
- Functional disruption of the capillary–alveolar membrane allows protein and fluid to move freely from the intravascular space into the alveolar space
- Pulmonary parenchymal changes are similar to CHF
- Concomitant CHF may occur in up to 20% of patients with acute respiratory distress syndrome (ARDS)
- Distinction between NCPE and CHF:
- Pulmonary capillary pressure ≤18 mm Hg
- Often apparent from the clinical circumstances
- The concentration of protein in the alveolar fluid is identical to that of the intravascular space in patients with NCPE
- Cephalad redistribution of blood flow, pulmonary effusions, and cardiomegaly are usually not present
- Adult respiratory distress syndrome:
- Clinical presentation caused by permeability pulmonary edema
- Associated with severe physiologic impairment
- Typically, onset of the edema is within 1–2 hr of the noxious insult.
- ∼250,000 cases occur each year in US
Etiology
Etiology
- ARDS is the #1 cause:
- Caused by:
- Sepsis
- Pneumonia
- Nonthoracic trauma
- Inhaled toxins
- Disseminated intravascular coagulation (DIC)
- Radiation pneumonitis
- Caused by:
- High-altitude pulmonary edema (HAPE) neurogenic pulmonary edema
- Narcotic overdose
- Pulmonary embolus
- Eclampsia
- Transfusion-related acute lung injury (TRALI)
- Re-expansion of a collapsed lung in patient with a pneumothorax
- Salicylate intoxication
- Inhaled cocaine use
- Near drowning
- HCTZ
- Uremia
- S/p cardiopulmonary bypass; especially if patient taking amiodarone
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Citation
* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Noncardiogenic Pulmonary Edema
ID - 307008
ED - Barkin,Adam Z,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Shayne,Philip,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307008/all/Noncardiogenic_Pulmonary_Edema
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -