Pulmonary edema natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Pulmonary edema}} | {{Pulmonary edema}} | ||
{{CMG}} | {{CMG}} {{AE}} {{FKH}} | ||
==Overview== | ==Overview== | ||
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==Natural History== | ==Natural History== | ||
* If left untreated, acute pulmonary edema can lead | * If left untreated, acute pulmonary edema can lead to respiratory arrest, [[coma]] and death, generally due to its main complication of [[Hypoxia (medical)|hypoxia]]<ref name="url2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure | European Heart Journal | Oxford Academic" /> | ||
* Some patients may need to use a breathing machine for a long time, which may lead to damage to [[lung]] [[tissue]] | * Some patients may need to use a breathing machine for a long time, which may lead to damage to [[lung]] [[tissue]] | ||
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* [[Respiratory arrest]] | * [[Respiratory arrest]] | ||
* [[Leg swelling]]([[edema]]) | * [[Leg swelling]] ([[edema]]) | ||
* [[Abdominal swelling]]([[ascites]]) | * [[Abdominal swelling]] ([[ascites]]) | ||
* [[Pleural effusion]] | * [[Pleural effusion]] | ||
* [[Congestion]] of liver | * [[Congestion]] of liver | ||
* [[Myocardial infarction]] | * [[Myocardial infarction]] (MI) | ||
* [[Cardiogenic shock]] | * [[Cardiogenic shock]] | ||
* [[Arrhythmias|Arrhythmia]]<nowiki/>s | * [[Arrhythmias|Arrhythmia]]<nowiki/>s | ||
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==Prognosis== | ==Prognosis== | ||
Prognosis of non-cardiogenic pulmonary edema is generally good and responds well to treatment, while cardiogenic pulmonary edema has a variable mortality rate. | |||
* In-hospital mortality rates in a high-acuity setting, are 15-20%. | * In-hospital mortality rates in a high-acuity setting, are 15-20%. | ||
The prognosis for patients with acute pulmonary edema depends on the:<ref name="url2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure | European Heart Journal | Oxford Academic">{{cite web |url=https://academic.oup.com/eurheartj/article/37/27/2129/1748921 |title=2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure | European Heart Journal | Oxford Academic |format= |work= |accessdate=}}</ref> | The prognosis for patients with acute pulmonary edema depends on the:<ref name="url2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure | European Heart Journal | Oxford Academic">{{cite web |url=https://academic.oup.com/eurheartj/article/37/27/2129/1748921 |title=2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure | European Heart Journal | Oxford Academic |format= |work= |accessdate=}}</ref> | ||
| Line 33: | Line 34: | ||
* The patient's age | * The patient's age | ||
* Comorbidities | * Comorbidities | ||
* | * Prompt diagnosis | ||
* Initiation of effective treatment | * Initiation of effective treatment | ||
The following features are associated with a worse outcome:<ref name="url2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure | European Heart Journal | Oxford Academic" /> | The following features are associated with a worse outcome:<ref name="url2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure | European Heart Journal | Oxford Academic" /> | ||
* Advanced Age | * Advanced Age | ||
* Wide [[QRS]] | * Wide [[QRS]] complex | ||
* [[Hyponatremia | * [[Hyponatremia]] | ||
* Low [[Left Ventricular Ejection Fraction]] | * Low [[Left Ventricular Ejection Fraction]] | ||
* [[Hypotension]] | * [[Hypotension]] | ||
Latest revision as of 20:15, 3 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]
Overview
Some patients may need to use a breathing machine for a long time, which may lead to damage to lung tissue. Kidney failure and damage to other major organs may occur if blood and oxygen flow are not restored promptly. If not treated, this condition can be fatal. If left untreated, acute pulmonary edema can lead to coma and even death, generally due to its main complication of hypoxia.
Natural History
- If left untreated, acute pulmonary edema can lead to respiratory arrest, coma and death, generally due to its main complication of hypoxia[1]
- Some patients may need to use a breathing machine for a long time, which may lead to damage to lung tissue
Complications
Common complications of pulmonary edema include:[1]
- Leg swelling (edema)
- Abdominal swelling (ascites)
- Pleural effusion
- Congestion of liver
- Myocardial infarction (MI)
- Cardiogenic shock
- Arrhythmias
- Electrolyte disturbances
- Mesenteric insufficiency
- Protein enteropathy
- Death
Prognosis
Prognosis of non-cardiogenic pulmonary edema is generally good and responds well to treatment, while cardiogenic pulmonary edema has a variable mortality rate.
- In-hospital mortality rates in a high-acuity setting, are 15-20%.
The prognosis for patients with acute pulmonary edema depends on the:[1]
- Underlying cause
- The patient's age
- Comorbidities
- Prompt diagnosis
- Initiation of effective treatment
The following features are associated with a worse outcome:[1]
- Advanced Age
- Wide QRS complex
- Hyponatremia
- Low Left Ventricular Ejection Fraction
- Hypotension
- Precipitated by ischaemia
- Previous hospitalisation for heart failure
- Marked BNP elevation
- Elevated troponin
References