Pulmonary Oedema

Question 1

What are the two classifications of pulmonary oedema? Give examples of each.

Answer 1

1. Haemodynamic pulmonary oedema:

• Increased Hydrostatic Pressure:
  
  • LVF
  • Mitral stenosis
  • Volume overload
  • Pulmonary vein obstruction
• Decreased oncotic pressure:
  
  • Hypoalbuminaemia eg:
    
    • nephrotic syndrome
    • liver disease
    • protein losing enteropathies
• Lymphatic obstruction

1. Oedema due to Microvascular Injury:

• ​​​​​​​Infection (mycoplasma, viruses)
• Inhaled agents (cyanide, smoke)
• Liquid aspiration (vomitus, near-drowning)
• Drugs and chemicals:
  
  • Chemotherapy
  • Medications (amphotericin, gold)
  • Other: heroin, paraquat, kerosine
• Shock, trauma and sepsis
• Radiation
• Miscellaneous, eg:
  
  • Pancreatitis
  • Embolism eg fat air or amniotic fluid
  • DKA
  • DIC
  • Uraemia

1. Oedema of unknown origin:

• ​​​​HAPE (altitude)
• Neurogenic