Cardiogenic pulmonary edema: mechanisms and treatment - an intensivist's view.

Abstract:

PURPOSE OF REVIEW:This review summarizes current understanding of the pathophysiology of cardiogenic pulmonary edema, its causes and treatment. RECENT FINDINGS:The pathobiology and classification of pulmonary edema is more complex than the hydrostatic vs. permeability dichotomy of the past. Mechanisms of alveolar fluid clearance and factors that affect the clearance rate are under intensive study to find therapeutic strategies. Patients need early stabilization of oxygenation and ventilation, preferably with high-flow nasal cannula oxygen or noninvasive ventilation whereas the diagnostic cause is quickly sought with echocardiography and other testing. SUMMARY:Treatments must be initiated early, whereas evaluation still is occurring and requires multimodality intervention. The general treatment of cardiogenic pulmonary edema includes diuretics, possibly morphine and often nitrates. The appropriate use of newer approaches - such as, nesiritide, high-dose vasodilators, milrinone, and vasopressin receptor antagonists - needs larger clinical trials.

journal_name

Curr Opin Crit Care

authors

Ingbar DH

doi

10.1097/MCC.0000000000000626

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

371-378

issue

4

eissn

1070-5295

issn

1531-7072

journal_volume

25

pub_type

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