पल्मोनरी इडिमा

थुकिगु लक्षणत खः

• सास ल्हाय् थाकुइगु,
• हेमोप्टाइसिस,
• यक्व चति वैगु,
• एंजाइटी व
• प्यालोर

थ्व अवस्थायु उपचार मयासा मनु हाइपोक्सिया जुया सी नं फु।

If pulmonary edema has been developing gradually, symptoms of fluid overload may be elicited. These include nocturia (frequent urination at night), ankle edema (swelling of the legs, generally of the "pitting" variety, where the skin is slow to return to normal when pressed upon), orthopnea (inability to lie down flat due to breathlessness) and paroxysmal nocturnal dyspnea (episodes of severe sudden breathlessness at night).

Pulmonary edema is generally suspected due to findings in the medical history, such as previous cardiovascular disease, and physical examination: end-inspiratory crackles (sounds heard at the end of a deep breath) on auscultation (listening to the breathing through a stethoscope) are characteristic for pulmonary edema. The presence of a third heart sound (S3) is predictive of cardiogenic pulmonary edema.^[१]

Blood tests are generally performed for electrolytes (sodium, potassium) and markers of renal function (creatinine, urea). Liver enzymes, inflammatory markers (usually C-reactive protein) and a complete blood count as well as coagulation studies (PT, aPTT) are typically requested. B-type natriuretic peptide (BNP) is available in many hospitals, especially in the US, sometimes even as a point-of-care test. Low levels of BNP (<100 pg/ml) make a cardiac cause very unlikely.^[१]

The diagnosis is confirmed on X-ray of the lungs, which shows increased fluid in the alveolar walls. Kerley B lines, increased vascular filling, pleural effusions, upper lobe diversion (increased blood flow to the higher parts of the lung) may be indicative of cardiogenic pulmonary edema, while patchy alveolar infiltrates with air bronchograms are more indicative of noncardiogenic edema^[१]

Low oxygen saturation and disturbed arterial blood gas readings may strengthen the diagnosis and provide grounds for various forms of treatment. If urgent echocardiography is available, this may strengthen the diagnosis, as well as identify valvular heart disease. In rare occasions, insertion of a Swan-Ganz catheter may be required to distinguish between the two main forms of pulmonary edema.^[१]

Pulmonary edema is either due to direct damage to the tissue or as a result of inadequate functioning of the heart or circulatory system.

कार्डियोजेनिक

• कन्जेस्टिभ नुग फेल्युवर
• तच्वगु ह्रिदयघाट with left ventricular failure
• तच्वगु कार्डियाक अरिदमिया (tachycardia/fast heartbeat or bradycardia/slow heartbeat)
• हाइपरटेन्सिभ क्राइसिस
• पेरिकार्डियल इफ्युजन टेम्पोनाड नापं
• फ्लुइड ओभरलोड, द्सुः- रेनल फेल्युवरनं

नन-कार्डियोजेनिक

This form is contiguous with ARDS (एक्ञुट रेस्पिरेटरी डिस्ट्रेस सिन्ड्रम):

• टक्सिक ग्यांस नतुनां
• यक्व हि ट्रान्स्फ्युजन
• तच्वगु संक्रमण
• पल्मोनरी कन्ट्युजन, i.e. तच्व-उर्जा ट्रमा
• मल्टीट्रमा, e.g. severe car accident
• न्युरोजेनिक, e.g. सबएराक्नोइड हेमोरेज
• पल्मोनरी एस्पिरेसन, e.g. gastric fluid or in case of drowning
• छुं वासलं
• च्वेयागु एअरवे अब्स्ट्रक्सन
• रिएक्स्पान्सन, i.e. पोस्टन्युमोनेक्टोमी वा यक्व थोर्‍याकोसेन्टेसिस
• रिपर्फ्युजन घा/इन्ज्युरी, i.e. postpulmonary थ्रोम्बोएन्डार्टेक्टोमी वा सों प्रत्यारोपण
• Ascent to high altitude occasionally causes high altitude pulmonary edema (HAPE)

Focus is initially on maintaining adequate oxygenation. This may happen with high-flow oxygen, noninvasive ventilation (either continuous positive airway pressure (CPAP) or variable positive airway pressure (VPAP)^[२][३]) or mechanical ventilation in extreme cases.

When circulatory causes have led to pulmonary edema, treatment with intravenous nitrates (glyceryl trinitrate), and loop diuretics, such as furosemide or bumetanide, is the mainstay of therapy. These improve both preload and afterload, and aid in improving cardiac function.

There are no causal therapies for direct tissue damage; removal of the causes (e.g. treating an infection) is the most important measure.

• High Altitude Pulmonary Edema
• Flash pulmonary edema

• Medical Encyclopedia entry