Pulmonary Oedema Management Flashcards
(12 cards)
What are some current symptoms of pulmonary oedema?
Dyspnoea, Pink frothy sputum, Symptoms suggestive of acute coronary event (angina)
Symptoms may indicate the severity of the condition.
What are the risk factors for pulmonary oedema?
Chronic heart failure:
- Paroxysmal Nocturnal Dyspnea
- Orthopnoea
- Exertional dyspnoea,
These factors can contribute to the development of pulmonary oedema.
What distinguishes cardiogenic from non-cardiogenic pulmonary oedema?
Non-cardiogenic pulmonary oedema is also called acute respiratory distress syndrome (ARDS) and can be caused by:
* Trauma
* Infection (sepsis)
* Massive blood transfusion
* Smoke inhalation
* Pancreatitis
ARDS has different causes and management compared to cardiogenic pulmonary oedema.
What signs are typically observed during a respiratory exam for pulmonary oedema?
What laboratory tests are important in the evaluation of pulmonary oedema?
- FBC (leukocytosis = infection)
- U&E (exclude electrolyte disturbances)
- LFTs (hypoalbuminemia)
- CRP (infection)
- Troponin (outrule acute MI)
- NT-proBNP (high negative predictive value to outrule heart failure)
These tests help identify underlying causes and complications.
What are typical ABG findings in pulmonary oedema?
Typically low PaO2 and low PaCO2 (type 1 respiratory failure)
ABG analysis is crucial for assessing respiratory function.
What chest X-ray findings are indicative of pulmonary oedema?
- Bilateral perihilar shadowing
- Blunting of costophrenic angles
- Fluid in the fissures
- Kerley B lines
- Cardiomegaly if cardiogenic cause
What initial treatment should be administered for pulmonary oedema?
- O2 via non-rebreather mask with 15L flow rate
- Consider CPAP if no improvement
- Sit patient upright in bed
- Stop IV fluids
- Diuretics (IV furosemide 40 mg)
- Catheterise to monitor fluid output to prevent dehydration
These interventions aim to stabilize the patient immediately.
What are the considerations for patients with hypotension in the context of pulmonary oedema?
- Diuretics may exacerbate hypotension
- Inotropes (e.g. dobutamine)
- Vasopressors (norepinephrine)
- Mechanical circulatory assistance
Special care is needed for patients with cardiogenic shock.
What is the first-line treatment for chronic heart failure?
ACE inhibitors and beta-blockers
These medications help manage heart failure symptoms and improve quality of life.
What are the second-line treatments for chronic heart failure?
Aldosterone antagonists (e.g. spironolactone, eplerenone)
Monitoring potassium levels is important with these medications.
Fill in the blank: __________ inhibitors are increasingly used for heart failure with reduced ejection fraction.
SGLT2
These inhibitors have shown promise in managing heart failure.
