Pulmonary Oedema Flashcards
(13 cards)
cardiogenic pulmonary oedema (CPO), symptoms
due to an increase in hydrostatic pressure of the pulmonary capillary blood secondary to left ventricular dysfunction or failure arising eg:
- hypertension
- MI
- ischaemic heart disease.
Symptoms:
- enlarged heart size
- high BNP (heart can’t pump properly)
HEART disease = CPO
non-cardogenic pulmonary oedema (NCPO), symptoms
due to leakiness of alveolar-capilary membrane are often associated with inflammation.
- near drowning experience
- mechanical ventilation
- lung infection
Symptom
- normal heart
- Low BNP (no heart problem)
Random events = NCPO
mechanisms that lead to pulmonary oedema (PO)
FII
- fluid build up in the capillaries of the lungs
- increases pressure in capillaries forces fluid out of the capillaries and into alveoli.
- increased fluid within alveoli decreases exchange of o2 and co2.
cellular level
- decrease in lymphatic drainage
- increase in capillary permeability
- increase in capillary hydrostatic pressure
causes of PO and how they give rise to PO
HAICADP
- hypertension
- acute respiratory distress syndrome (ARDS) - a severe medical condition causing widespread inflammation in the lungs can be triggered by COVID or influenza
- inhalation of toxic gases
- cardiomyopathy - deterioration of heart function
- asthma
- drug damage to endothelial cell layer in lung
- prolong exposure to high altitudes
how gas exchange in the lung alveoli become impaired in PO?
- increased fluid within the alveoli which decreases o2 exchange. (o2 leaves alveolar)
- damage to alveolar capillary membrane and epithelial cells.
cellular events that lead to CPO (3)
- a increased hydrostatic pressure
- transport of Na+, Cl- and H2o is drives removal of alveolar edema
- protein poor fluid in alveoli
cellular events that leads to NCPO (5 p)
- a normal hydrostatic pressure
- disrupted epithelial barrier
- broken transport of Na+, Cl- and H2o.
- white blood cells enter (macrophages and neutrophils)
- protein rich edema fluid
symptoms of PO (7)
DIHCIFS
Dyspnea - shortness of breathing and breathing is hard
Inability to lie down
Hypoxia - decreased o2 in blood
Coughing - pink froth (blood in lung)
Inspiratory crackles and wheezes - due to water in alveoli
Fast heart rate, pale and sweating - due to activation of SNS(sympathetic nervous system)
what histological changes that could occur in PO patient?
- signs of infection
- decrease level of consciousness + vomiting
- trauma
- accidental exposer to chemicals
- details of medications and ingestions
Treatment for PO
- mask up patient with o2
- patient in a sitting position to reduce venous return.
- morphine (pain reduction and reduce sympathetic activity)
Pulmonary oedema and common cause?
- too much fluid in lungs.
- common cause is congestive heart failure.
diagnosis of PO
- blood o2 saturation levels - pulse oximetry
- chess x-ray - fluid in lungs and around , large heart and white on x-ray is fluid
- ultrasounds of heart (ECHO) - weak heart, narrow heart valves and fluid around heart.
- BNP (brain natriuretic peptide) - indicate heart failure
what measures are done to exclude myocardial infarction from treatment and diagnosis CPO?
ECG and troponin
