How swelling occurs
Lung edema - a pathological increase in volumeextravascular fluid in the lungs. When swelling of the lungs in the spaces outside the pulmonary blood vessels fluid is collected. In one of the types of edema, the so-called cardiogenic pulmonary edema, fluid swelling is caused by increased pressure in the pulmonary veins and capillaries. As a complication of heart disease, pulmonary edema can become chronic, but there may be acute pulmonary edema, which quickly develops and can lead to the death of the patient in a short time.
Diagnosis by symptoms
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Usually, pulmonary edema occurs for a reasonfailure of the left ventricle, the main chamber of the heart, which arose as a result of heart disease. In certain heart diseases, more pressure is required to fill the left ventricle in order to ensure sufficient blood flow to all parts of the body. Accordingly, the pressure in the other chambers of the heart and in the pulmonary veins and capillaries rises.
Gradually a part of the blood swims into the spacesbetween the tissues of the lung. This prevents the spread of the lungs and disrupts the gas exchange that occurs in them. In addition to heart disease, there are other factors predisposing to pulmonary edema:
- excess blood in the veins;
- some kidney diseases, extensive burns, a diseased liver, nutritional deficiencies;
- violation of the outflow of lymph from the lungs, as observed in Hodgkin's disease;
- decrease in blood flow from the left upper chamber of the heart (for example, when the mitral valve is narrowed);
- disorders that cause blockage of the pulmonary veins.
- sudden attacks of respiratory distress after several hours of sleep;
- difficulty breathing, which is facilitated in a sitting position;
When a patient is examined,rapid pulse, rapid breathing, abnormal sounds during listening, swelling of the cervical veins and deviations from normal heart tones. With severe pulmonary edema, when the alveolar sacs and small airways are filled with fluid, the patient's condition worsens. Breathing becomes more frequent, it becomes difficult, with a coughing foamy sputum with traces of blood. The pulse becomes more frequent, heart rhythms are broken, the skin becomes cold, sticky and acquires a bluish tinge, sweating increases. Since the heart pumps less and less blood, the blood pressure drops, the pulse becomes threadlike.
The diagnosis of pulmonary edema is based onsymptoms and physical examination, then the study of gases contained in the arterial blood, which usually shows a decrease in the oxygen content, is assigned. At the same time, acid-base balance and acid-base balance, as well as metabolic acidosis, can be found. X-ray examinations of the chest usually reveal diffuse darkening in the lungs and often hypertrophy of the heart and excess fluid in the lungs. In some cases, a catheterization of the pulmonary artery is used for diagnostic purposes, which can confirm left ventricular failure and exclude adult respiratory distress syndrome, the symptoms of which are similar to the symptoms of pulmonary edema.
When examining a patient during an attack, drawsattention to the appearance of the patient, forced position in bed, characteristic behavior (agitation and fear). At a distance, wheezing and noisy breathing can be heard. When listening (auscultation) of the heart there is a marked tachycardia (rapid heartbeat to 150 beats per minute and more), breathing bubbling, heart sounds are not listened because of the "noise" in the chest. The thorax expands. ECG (electrocardiogram) - during pulmonary edema on a cardiogram, there is a violation of the rhythm of the heart (from tachycardia to serious disturbances up to myocardial infarction). Pulse oximetry (method of determining blood saturation, oxygen) - when swelling of the lung is determined by a sharp decrease in oxygen in the blood to 90%.Treatment of pulmonary edema should be carried out inconditions of intensive care unit (ward). The tactics of treatment, directly depends on the parameters of consciousness, heart rate, blood pressure and in each individual case can differ drastically. The general principles of treatment are:
- Reducing the excitability of the respiratory center.
- Increased contractility of the heart.
- Unloading of the small circle of blood circulation.
- Oxygenotherapy (saturation of blood with oxygen).
- The use of sedative (soothing) drugs.
The patient is given a semi-sitting position in thebeds, legs are lowered to the floor to reduce the return of blood to the heart. To reduce the excitability of the respiratory center and reduce the pressure in a small circle of blood circulation, 1 ml of 1% morphine solution is administered. With expressed excitement, 2 ml of droperidol is administered intravenously. In severe tachycardia, 1 ml of a 1% solution of dimedrol or suprastin is administered. Oxygenotherapy (oxygenation of the blood, by inhalation) is carried out by connecting the patient to the apparatus with oxygen or oxygen supplied with alcohol vapors (to saturate the blood with oxygen and reduce foaming). At a normal arterial pressure, diuretics of 80 mg furosemide are injected intravenously.
To improve the contractility of the heartEnter cardiac glycosides (1ml solution of Korglikona or 0.5 ml of solution strofantina, previously diluted in 20 ml of physiological solution). To discharge the myocardium take nitroglycerin 1 tablet under the tongue and in parallel intravenously drip a solution of nitroglycerin (under the control of blood pressure). ACE inhibitors (enalapril) are used to expand the blood vessels and reduce the burden on the heart. It should be borne in mind that against the background of pulmonary edema, blood pressure can either decline (up to a shock) or rise (before the hypertensive crisis), the heart rhythm can be disturbed. Treatment should be carried out under the control of the patient's condition and constant measurement of blood pressure.
Questions and answers on "Pulmonary edema"
Question:Hello! What are the complications of pulmonary edema?
Answer: Most complications of pulmonary edema are associated withits main cause. More specifically, pulmonary edema can threaten severe hypoxia and, as a consequence, the onset of oxygen starvation of all organs and systems, including such vital ones as the brain, with all the ensuing consequences.
Question:Tell me, but at high temperatures it is possibleinstant pulmonary edema with a lethal outcome? Just a person with a high temperature went to work, where he happened badly. He got into resuscitation and within 5 days burned out of instant pulmonary edema. Really nothing could be done?
Answer: Unfortunately, with flu, especially H1N1, a lightning-fast course of the disease is possible, which, despite active and complete treatment, can lead to pulmonary edema and death.
Question:To father 52 years, is ill with a diabetes mellitus the seconddegree. On tablets. The sugar level is normal all the time 3-5 units. At a birthday, after apparently a large amount of alcohol all day sick, and very hard to breathe, in fact, suffocating. All this occurred from early morning to evening. By the evening it was better, but when I went to bed I started to choke again. At night they dialed 03. They called an ambulance, they said that there was pulmonary edema, but there was no infarction. The cardiogram is bad. Is all this dangerous for him?
Answer: Yes, unfortunately, it is really dangerous. With the concomitant pathology - diabetes, any pathological conditions are much more difficult to treat. With timely rendered and qualified assistance, even in this condition, the forecast can be positive.
Question:How quickly recover lungs after swelling?
Answer: This, first of all, depends on what causedpulmonary edema. And on what methods they were restored. For example, a slight mountain swelling of the lungs does not make itself felt in a day or two after descent to the plain.
Question:Why does the lungs swell? What to do to prevent or prevent it?
Answer: Pulmonary edema - congestion in the pulmonary vesicles(alveoli) and in the tissues of light watery fluid. This is not an independent disease, but a serious complication of other diseases. It occurs as a result of stagnation of blood in the lungs caused by heart failure in heart defects, hypertension, myocardial infarction, acute inflammation of the kidneys, uremia. Edema can also occur on the ground of inflammatory or toxic damage to the vessels of the lungs, as well as with prolonged lying of the patient in bed.
Question:Tell me, what is swelling there And for what? Is the bronchi swelling or something else called edema?
Answer: Lung edema is due to an overabundance of blood in thelungs, when the pressure in the pulmonary capillaries is too high, the fluid from them swells into the alveoli and this breaks the gas exchange. It happens with left ventricular heart failure, pulmonary embolism, with increased permeability of pulmonary vessels due to some reasons, for example, in sepsis, chest trauma, pancreatitis, pneumonia, throwing up gastric contents, water and other liquids in the respiratory tract, inhaling toxic gases (ozone, chlorine, phosgene), smoke, mercury vapors, water and other vapors, with renal insufficiency.