Disorders of Pulmonary Circulation Flashcards
What are the treatments for high pressure pulmonary edema?
• Oxygen, noninvasive mask ventilation • Decrease preload – nitrates, diuretics, venodilators • Decrease afterload – ACE inhibitors, hydralazine • Increase contractility – Dobutamine, milrinone
What are the treatments for low pressure pulmonary edema?
• Fix the underlying problem • Lower the hydrostatic pressures • Mechanical Ventilation – High PEEP – Low tidal volumes • Salvage therapy- ECMO
What is the main cause of high pressure pulmonary edema?
Elevated LVEDP causes elevated hydrostatic pressures which result in increased edema formation
What are the exam signs of high pressure pulmonary edema?
JVD, S3, hepatomegaly, edema, cool extremities, thready pulse
What is the main cause of low pressure pulmonary edema?
Increased permeability (leaky capillaries) - sepsis/trauma related
What is the type of edema in low pressure pulmonary edema?
Exudate
What is the main condition where low pressure pulmonary edema can occur?
ARDS
What are the exam signs of low pressure pulmonary edema?
– Lack of signs of elevated filling pressures.
– If sepsis is the underlying cause, there are typically warm extremities, bounding pulses and a wide pulse pressure.
What type of pulmonary edema will have peripheral edema?
High Pressure
What is ECMO?
Extra Corporeal Membrane Oxygenation - with a large catheter into the internal jugular vein and it performs oxygenation of the blood
What are some risk factors of pulmonary embolism?
- Previous venous thromboembolism
- Age>40
- Immobility, paralysis
- Malignancy
- Major surgery
- Trauma
- Obesity
- Cardiac disease
- Long bone fractures
- CVA
- Nephrotic syndrome
- Estrogens
- Femoral lines
- Parturition
- Hypercoag. states
What are some helpful diagnostic tests for pulmonary embolism?
- D-dimer is only helpful if it is negative
- Lower extremity ultrasonography helpful if positive
