Acute Pulmonary Oedema

Question 1

what is pulmonary oedema?

Answer 1

condition caused by excess fluid in the lungs

Question 2

what are the clinical symptoms of acute pulmonary oedema?

Answer 2

• extreme dyspnoea
• restlessness
• anxiety
• frothy sputum

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Question 3

what are the clinical signs of acute pulmonary oedema?

Answer 3

• bilateral reduced air entry
• inspiratory crepitations
• raised JVP
• S3 gallop
• peripheral oedema

signs of fluid overload

Question 4

what can precipitate pulmonary oedema?

Answer 4

• cardiac ischaemia
• arrhythmias
• non-compliance with regular heart failure medication

Question 5

what investigations can be done in acute pulmonary oedema?

Answer 5

• bedside observations
• arterial blood gas
• ECG
• troponin
• serum BNP
• chest x-ray

Question 6

what is the management of acute pulmonary oedema?

Answer 6

1. ABCDE
2. sit the patient up
3. administer oxygen
4. ensure IV access
5. IV furosemide
6. consider non-invasive ventilation - e.g. CPAP
7. consider futher therapies in the ICU

Question 7

name some inotropes which can be used in severe acute pulmonary oedema?

Answer 7

• dobutamine
• milrinone

Question 8

what do you do to the dose of furosemide in a patient with acute pulmonary oedema and AKI?

Answer 8

increase the dose

so that an increased conc reaches the glomerulus and tubules