Respiratory disorders: Pulmonary edema

Question 1

What two pathophysiologic forms are used to describe the pathogenesis of pulmonary edema?

Answer 1

High pressure edema = increased pulmonary capillary hydrostatic pressure

Increased-permeability edema = result of a damaged alveolar epithelium and barriers

Question 2

What would be expected to be heard on pulmonary auscultation on a patient with pulmonary edema?

Answer 2

Crackles, or loud coarse lung sounds; distribution or localization can help with diagnosis (cranioventral with aspiration pneumonia, perihilar with cardiogenic pulmonary edema)

Question 3

Treatment for patients with cardiogenic pulmonary edema include -?

Answer 3

While oxygen supplementation and fluid therapy should be carefully considered, a decrease in preload through diuretics and vasodilator is the mainstay of treatment.

Furosemide acts as a diuretic, pulmonary venodilator, and bronchodilator for high pressure edema (rather than increased permeability)

Nitric oxide donors for arteriodilators are recommended (Nitroprusside)

Question 4

Treatment for patients with increased permeability pulmonary edema include -? (Broad, drug classes based on MoA, e.g. calcium channel blockers, etc.)

Answer 4

Beta-2 agonists and Alpha antagonists