At the heart leading to swelling processesmost cases are any hemodynamic disturbances, usually caused by a pathology or acute cardiac overload (cardiogenic pulmonary edema), or diseases such as pneumonia, sepsis, aspiration of gastric contents, or injury (non-cardiogenic pulmonary edema), or damage alveolokapillyarnyh membranes toxic substances (toxic lung edema ), food allergy (allergic pulmonary edema), due to hypoxia; often develops in patients with brain damage. Drastic violations of metabolic processes in the body if left untreated, pulmonary edema result in death of the patient.
There are acute pulmonary edema, which developsfor 2-4 hours, and prolonged pulmonary edema develops within a few hours and sometimes lasting a day or more, as well as lightning-fast form of pulmonary edema, in which the death occurs within a few minutes from the beginning of its development (eg acute myocardial infarction).
When alveolar edema (subsequent heavierstage, when the liquid is already in the lumen of the alveoli) which can develop very rapidly, sometimes as if suddenly (such as during sleep), the patient rapidly progressing dyspnea, developing into asthma, respiratory rate increases to 30-40 per minute, on the face appear profuse perspiration, marked blue tongue, the skin becomes grayish hue. Heavy breathing is interrupted by coughs, released copious frothy, often pink (bloody) sputum. Patients are excited to experience the fear of death.
In the breast over the entire surface of the lungs are determinedfinely, subsequently mixed wet rales with a predominance krupnopuzyrchatyh; there is rattling in the large bronchi and trachea, audible at a distance (bubbling breath). Growing tachycardia, sometimes muffled heart sounds so that they can not hear because of the noisy breathing. The pulse becomes small and frequent, blood pressure tends to decrease, and the occurrence of pulmonary edema on the background of vascular insufficiency aggravates it up to the development of severe collapse. The diagnosis is confirmed by X-rays.
In general, the treatment comprises:
- giving the patient a comfortable semi-sitting or sitting position (except for a combination of pulmonary edema with severe collapse);
- overlapping venous tourniquet on the thigh to restrict the blood flow to the heart and lungs;
- inhalation of oxygen through a mask or nasal catheter
- suctioning foam and liquid from the trachea and major bronchi, optionally applying artificial respiration pressure, i.e. conducting resuscitation measures;
- complete elimination of pain (the introduction of neuroleptics);
- correction of cardiac arrhythmias;
- correction of disorders of acid-base balance (combating acidosis);
- correction of electrolyte balance;
- reduction of hydrostatic pressure in the vesselspulmonary circulation (narcotic analgesics are misleading, inhibiting the respiratory center, reduced shortness of breath, reduced venous return and blood pressure, relieve anxiety and fear of death);
- reduction of venous flow to the right ventricle (introduction ganglioblokatorov);
- dehydration of the lungs (diuretics are used, bleeding);
- strengthening myocardial contractility (administered cardiac glycosides - strofantin);