Pulmonary edema
Updates to Article Attributes
Body
was changed:
Pulmonary oedema is a broad descriptive term and is usually defined as an abnormal accumulation of fluid in the extra-vascular compartments of the lung 1.
Pathology
One method of classifying pulmonary oedema is as four main categories on the basis of pathophysiology which include:
- increased hydrostatic pressure oedema
- two pathophysiological and radiological phases are recognized in the development of pressure oedema
- these phases are virtually identical for left-sided heart failure and fluid overload
- permeability oedema with diffuse alveolar damage (DAD)
- permeability oedema without diffuse alveolar damage
- mixed
edemaoedema due to simultaneous increased hydrostatic pressure and permeability changes
It can arise from a range of both cardiogenic and non-cardiogenic causes.
Causes
- cardiogenic pulmonary oedema:
-
non cardiogenic pulmonary oedema: useful mnemonic: NOTCARDIAC
- fluid overload
- pulmonary oedema with acute asthma
- post-obstructive pulmonary oedema/ post intubation pulmonary oedema
- pulmonary oedema in pulmonary thromboembolism
- pulmonary oedema due to air embolism
- pulmonary veno-occlusive disease
- near drowning pulmonary oedema / asphyxiation pulmonary oedema
- ARDS - pulmonary oedema with diffuse alveolar damage
- heroin-induced pulmonary oedema
- pulmonary oedema following administration of cytokines
- transfusion related acute lung injury
- high-altitude pulmonary oedema
- neurogenic pulmonary oedema
- reperfusion pulmonary oedema
- pulmonary oedema following lung transplantation
- re-expansion pulmonary oedema
- post-pneumonectomy pulmonary oedema
- post lung volume reduction pulmonary oedema
- pulmonary oedema from anti snake venom administration 8
Radiographic features
Plain radiograph
The chest radiograph still remains the most practical and useful method of radiologically assessing and quantifying pulmonary oedema 3-4.
Features useful for broadly assessing pulmonary oedema on a plain radiograph include:
- cardiac size/cardio-thoracic ratio: useful for assessing for an underlying cardiogenic cause or association
- bat wing pulmonary opacities
- presence of peri-bronchial cuffing
- septal lines: Kerley lines
- pleural effusions
-
pulmonary venous engorgement
/pulmonary/ pulmonary blood flow distribution/upper lobe pulmonary venous diversion
Some of these features can vary dependentdepending on the cause and is best addressed on individual articles 1.
Differential diagnosis
General imaging differential considerations include:
- diffuse pulmonary haemorrhage: has no dependent gradient and usually no pleural effusion
- diffuse pulmonary infection 6: usually no dependent gradient
See also
-<li>mixed edema due to simultaneous increased hydrostatic pressure and permeability changes</li>- +<li>mixed oedema due to simultaneous increased hydrostatic pressure and permeability changes</li>
-<a href="/articles/pulmonary-venous-engorgement">pulmonary venous engorgement</a>/pulmonary blood flow distribution/<a href="/articles/upper-lobe-pulmonary-venous-diversion">upper lobe pulmonary venous diversion</a>- +<a href="/articles/pulmonary-venous-engorgement">pulmonary venous engorgement</a> / pulmonary blood flow distribution / <a href="/articles/upper-lobe-pulmonary-venous-diversion">upper lobe pulmonary venous diversion</a>
-</ul><p>Some of these features can vary dependent on the cause and is best addressed on individual articles <sup>1</sup>.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>- +</ul><p>Some of these features can vary depending on the cause and is best addressed on individual articles <sup>1</sup>.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>
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