Pulmonary edema

Last updated: June 30, 2023

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Summarytoggle arrow icon

Pulmonary edema is the accumulation of fluid in the lungs. The cause can be cardiogenic (e.g., acute myocardial infarction, congestive heart failure) or noncardiogenic (e.g., pneumonia, blood transfusion, preeclampsia, shock). Clinical features include progressive dyspnea and signs of hypoxemia (e.g., cyanosis, tachycardia). Cardiogenic pulmonary edema furthermore manifests with elevated jugular venous pressure and an S3 gallop on cardiac auscultation. Diagnosis and, especially, differentiation of causes involves laboratory studies, chest x-ray, and ECG as well as patient history and physical examination. Management involves oxygen supplementation and, depending on the cause, diuretics, morphine, and/or drugs to control blood pressure. Ventilatory support may be necessary in severe cases. Complications include acute respiratory distress syndrome (ARDS) and respiratory failure.

Classificationtoggle arrow icon

Types of pulmonary edema [2][3]
Cardiogenic pulmonary edema Noncardiogenic pulmonary edema
  • An accumulation of fluid in the lungs due to an increase in permeability of the pulmonary capillaries (fluid is rich in proteins)

Clinical featurestoggle arrow icon

Diagnosticstoggle arrow icon

Managementtoggle arrow icon

Complicationstoggle arrow icon

We list the most important complications. The selection is not exhaustive.

Flash pulmonary edematoggle arrow icon

Referencestoggle arrow icon

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  6. Assaad S, Kratzert WB, Shelley B, Friedman MB, Perrino A Jr. Assessment of Pulmonary Edema: Principles and Practice.. J Cardiothorac Vasc Anesth. 2018; 32 (2): p.901-914.doi: 10.1053/j.jvca.2017.08.028 . | Open in Read by QxMD
  7. $Contributor Disclosures - Pulmonary edema. All of the relevant financial relationships listed for the following individuals have been mitigated: Jan Schlebes (medical editor, is a shareholder in Fresenius SE & Co KGaA). None of the other individuals in control of the content for this article reported relevant financial relationships with ineligible companies. For details, please review our full conflict of interest (COI) policy.
  8. Kaplan JA. Kaplan's Cardiac Anesthesia E-Book. Elsevier Health Sciences ; 2016
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  10. Rimoldi SF, Yuzefpolskaya M, Allemann Y, Messerli F. Flash Pulmonary Edema. Prog Cardiovasc Dis. 2009; 52 (3): p.249-259.doi: 10.1016/j.pcad.2009.10.002 . | Open in Read by QxMD
  11. Messerli FH, Bangalore S, Makani H, et al. Flash pulmonary oedema and bilateral renal artery stenosis: the Pickering Syndrome. Eur Heart J. 2011; 32 (18): p.2231-2235.doi: 10.1093/eurheartj/ehr056 . | Open in Read by QxMD
  12. Long B, Koyfman A, Gottlieb M. Management of Heart Failure in the Emergency Department Setting: An Evidence-Based Review of the Literature. J Emerg Med. 2018; 55 (5): p.635-646.doi: 10.1016/j.jemermed.2018.08.002 . | Open in Read by QxMD

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