Neurogenic pulmonary edema: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(14 intermediate revisions by the same user not shown)
Line 3: Line 3:
{{CMG}}, {{AE}} {{SHH}}
{{CMG}}, {{AE}} {{SHH}}
==Overview==
==Overview==
Neurogenic [[pulmonary edema]] usually appears within minutes to hours after a [[Brain|cerebral]] injury. It is an acute life-threatening [[Complication (medicine)|complication]] associated with many forms of [[central nervous system]] injury, such as [[brain]] or [[spinal cord]] [[Bleeding|hemorrhage]], [[Physical trauma|trauma]], [[Tumor|tumors]], [[epilepsy]] and [[Infection|infections]]. The pathogenetic factors for the its onset include increased [[intracranial pressure]] and severe over-activation of the [[sympathetic nervous system]]. Neurogenic [[pulmonary edema]] must be differentiated from other diseases with same symptoms, include [[aspiration pneumonia]], [[Pulmonary edema, cardiogenic|cardiogenic pulmonary edema]], [[angioedema]] and [[Asthma|asthma attack]]. NPE is characterized by [[dyspnea]], bilateral basal pulmonary [[Rales|crackles]] and the other signs and symptoms of [[pulmonary edema]], in the absence of cardiac failure. [[Arterial blood gas]] test shows [[hypoxemia]], [[hypercapnia]] and [[acidosis]]. In treatment of neurogenic [[pulmonary edema]], the main principle is supportive treatment and decreasing [[intracranial pressure]] as in [[acute respiratory distress syndrome]].


==Historical Perspective==
==Historical Perspective==
*[Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
*In 1908, W. T. Shanahan noted acute [[pulmonary edema]] as an adverse effect of [[epileptic seizures]].
*In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
*During WWI, francois Moutier noted the sudden onset of [[pulmonary edema]] among soldiers shot in the head.<ref name="pmid22429697">{{cite journal |vauthors=Davison DL, Terek M, Chawla LS |title=Neurogenic pulmonary edema |journal=Crit Care |volume=16 |issue=2 |pages=212 |date=December 2012 |pmid=22429697 |pmc=3681357 |doi=10.1186/cc11226 |url=}}</ref><ref name="pmid29123866">{{cite journal |vauthors=Izumida H, Homma K, Sasaki J, Hori S |title=Pulmonary edema following tonic-clonic seizure |journal=Acute Med Surg |volume=4 |issue=2 |pages=221–222 |date=April 2017 |pmid=29123866 |pmc=5667274 |doi=10.1002/ams2.251 |url=}}</ref>
*In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].
*In the Vietnam War, [[alveolar]] [[edema]] and [[hemorrhage]] seen in the [[Lung|lungs]] of soldiers dying after isolated bullet head wounds.<ref name="pmid5789529">{{cite journal |vauthors=Simmons RL, Heisterkamp CA, Collins JA, Genslar S, Martin AM |title=Respiratory insufficiency in combat casualties. 3. Arterial hypoxemia after wounding |journal=Ann. Surg. |volume=170 |issue=1 |pages=45–52 |date=July 1969 |pmid=5789529 |pmc=1387602 |doi= |url=}}</ref>
==Classification==
*[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
:*[group1]
:*[group2]
:*[group3]
*Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
   
   
==Pathophysiology==
==Pathophysiology==
*Pulmonary edema may develop in the setting of a sudden neurologic event. Neurogenic pulmonary edema usually appears within minutes to hours after cerebral injury.<ref name="pmid9149590">{{cite journal |vauthors=Smith WS, Matthay MA |title=Evidence for a hydrostatic mechanism in human neurogenic pulmonary edema |journal=Chest |volume=111 |issue=5 |pages=1326–33 |date=May 1997 |pmid=9149590 |doi= |url=}}</ref><ref name="pmid231156932">{{cite journal |vauthors=Kim JE, Park JH, Lee SH, Lee Y |title=Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report- |journal=Korean J Anesthesiol |volume=63 |issue=4 |pages=368–71 |date=October 2012 |pmid=23115693 |pmc=3483499 |doi=10.4097/kjae.2012.63.4.368 |url=}}</ref>
*[[Pulmonary edema]] may develop in the setting of a sudden [[Neurology|neurologic]] event. Neurogenic [[pulmonary edema]] usually appears within minutes to hours after [[Brain|cerebral]] injury.<ref name="pmid9149590">{{cite journal |vauthors=Smith WS, Matthay MA |title=Evidence for a hydrostatic mechanism in human neurogenic pulmonary edema |journal=Chest |volume=111 |issue=5 |pages=1326–33 |date=May 1997 |pmid=9149590 |doi= |url=}}</ref><ref name="pmid231156932">{{cite journal |vauthors=Kim JE, Park JH, Lee SH, Lee Y |title=Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report- |journal=Korean J Anesthesiol |volume=63 |issue=4 |pages=368–71 |date=October 2012 |pmid=23115693 |pmc=3483499 |doi=10.4097/kjae.2012.63.4.368 |url=}}</ref>
*Neurogenic pulmonary edema is an acute life-threatening complication associated with many forms of central nervous system injury, such as:<ref name="pmid231156932">{{cite journal |vauthors=Kim JE, Park JH, Lee SH, Lee Y |title=Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report- |journal=Korean J Anesthesiol |volume=63 |issue=4 |pages=368–71 |date=October 2012 |pmid=23115693 |pmc=3483499 |doi=10.4097/kjae.2012.63.4.368 |url=}}</ref>
*Neurogenic [[pulmonary edema]] is an acute life-threatening [[Complication (medicine)|complication]] associated with many forms of [[central nervous system]] injury, such as:<ref name="pmid231156932">{{cite journal |vauthors=Kim JE, Park JH, Lee SH, Lee Y |title=Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report- |journal=Korean J Anesthesiol |volume=63 |issue=4 |pages=368–71 |date=October 2012 |pmid=23115693 |pmc=3483499 |doi=10.4097/kjae.2012.63.4.368 |url=}}</ref>
**Brain or spinal cord hemorrhage
**[[Brain]] or [[spinal cord]] hemorrhage
**Trauma
**[[Physical trauma|Trauma]]
**Tumors
**[[Tumor|Tumors]]
**Epilepsy
**[[Epilepsy]]
**Infections
**[[Infection|Infections]]
*The pathogenetic factors for the onset of neurogenic pulmonary edema include:<ref name="pmid23115693">{{cite journal |vauthors=Kim JE, Park JH, Lee SH, Lee Y |title=Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report- |journal=Korean J Anesthesiol |volume=63 |issue=4 |pages=368–71 |date=October 2012 |pmid=23115693 |pmc=3483499 |doi=10.4097/kjae.2012.63.4.368 |url=}}</ref>
*The pathogenetic factors for the onset of neurogenic [[pulmonary edema]] include:<ref name="pmid23115693">{{cite journal |vauthors=Kim JE, Park JH, Lee SH, Lee Y |title=Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report- |journal=Korean J Anesthesiol |volume=63 |issue=4 |pages=368–71 |date=October 2012 |pmid=23115693 |pmc=3483499 |doi=10.4097/kjae.2012.63.4.368 |url=}}</ref>
**Increased intracranial pressure
**Increased [[intracranial pressure]]
**Severe over-activation of the sympathetic nervous system
**Severe over-activation of the [[sympathetic nervous system]]
*Neurogenic pulmonary edema may develop as a result of activation of specific CNS trigger zones in the brainstem, leading to a rapid sympathetic discharge, rise in systemic blood pressure, baroreflex-induced bradycardia, and enhanced venous return. These cause pulmonary vascular congestion characterized by interstitial edema, intra-alveolar accumulation of transudate and hemorrhages.<ref name="pmid25496372">{{cite journal |vauthors=Šedý J, Kuneš J, Zicha J |title=Pathogenetic Mechanisms of Neurogenic Pulmonary Edema |journal=J. Neurotrauma |volume=32 |issue=15 |pages=1135–45 |date=August 2015 |pmid=25496372 |doi=10.1089/neu.2014.3609 |url=}}</ref>
*Neurogenic [[pulmonary edema]] may develop as a result of activation of specific [[CNS]] trigger zones in the [[Brain stem|brainstem]], leading to a rapid [[Sympathetic control|sympathetic]] discharge, rise in systemic [[blood pressure]], [[baroreflex]]-induced [[bradycardia]], and enhanced [[venous return]]. These cause pulmonary vascular [[congestion]] characterized by [[interstitial edema]], intra-alveolar accumulation of [[transudate]] and [[Bleeding|hemorrhages]].<ref name="pmid25496372">{{cite journal |vauthors=Šedý J, Kuneš J, Zicha J |title=Pathogenetic Mechanisms of Neurogenic Pulmonary Edema |journal=J. Neurotrauma |volume=32 |issue=15 |pages=1135–45 |date=August 2015 |pmid=25496372 |doi=10.1089/neu.2014.3609 |url=}}</ref>
*The initiating mechanism may be a marked, although brief, generalized vasoconstriction, followed by a shift of blood from the peripheral vascular bed to the pulmonary vascular bed.<ref name="pmid64378962">{{cite journal |vauthors=Piatti L, Locatelli V, Ferracini C, Sozzi G |title=[Neurogenic pulmonary edema. Description of a case occurring after an epileptic crisis] |language=Italian |journal=G Ital Cardiol |volume=14 |issue=8 |pages=602–5 |date=August 1984 |pmid=6437896 |doi= |url=}}</ref>
*The initiating mechanism may be a marked, although brief, generalized [[vasoconstriction]], followed by a shift of blood from the peripheral vascular bed to the pulmonary vascular bed.<ref name="pmid64378962">{{cite journal |vauthors=Piatti L, Locatelli V, Ferracini C, Sozzi G |title=[Neurogenic pulmonary edema. Description of a case occurring after an epileptic crisis] |language=Italian |journal=G Ital Cardiol |volume=14 |issue=8 |pages=602–5 |date=August 1984 |pmid=6437896 |doi= |url=}}</ref>
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
 
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
==Differentiating neurogenic pulmonary edema from other Diseases==
*Neurogenic [[pulmonary edema]] must be differentiated from other diseases with same symptoms, include:<ref name="pmid1629591">{{cite journal |vauthors=Pender ES, Pollack CV |title=Neurogenic pulmonary edema: case reports and review |journal=J Emerg Med |volume=10 |issue=1 |pages=45–51 |date=1992 |pmid=1629591 |doi= |url=}}</ref>
**[[Aspiration pneumonia]]
**[[Pulmonary edema, cardiogenic|Cardiogenic pulmonary edema]] (such as [[Heart failure resident survival guide|acute heart failure]] and [[Cardiac tamponade|pericardial tamponade]])
**[[Angioedema]]
**[[Anaphylaxis]]
**[[Asthma|Asthma attack]]
**[[Atelectasis]]
**[[Bronchitis]]
**[[Chronic obstructive pulmonary disease|COPD]] exacerbation
**[[Pneumonia]]


==Clinical Features== 
* For more information about [[differential diagnosis]] of [[pulmonary edema]] click '''''[[Pulmonary edema|here]]'''''.


==Differentiating [disease name] from other Diseases==
*Neurogenic pulmonary edema must be differentiated from other diseases with same symptoms, include:<ref name="pmid1629591">{{cite journal |vauthors=Pender ES, Pollack CV |title=Neurogenic pulmonary edema: case reports and review |journal=J Emerg Med |volume=10 |issue=1 |pages=45–51 |date=1992 |pmid=1629591 |doi= |url=}}</ref>
**Aspiration pneumonia
==Epidemiology and Demographics==
==Epidemiology and Demographics==
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
*The [[incidence]] of neurogenic [[pulmonary edema]] is approximately 2000 to 42900 per 100,000 individuals in patients with [[subarachnoid hemorrhage]].<ref name="pmid126580012">{{cite journal |vauthors=Fontes RB, Aguiar PH, Zanetti MV, Andrade F, Mandel M, Teixeira MJ |title=Acute neurogenic pulmonary edema: case reports and literature review |journal=J Neurosurg Anesthesiol |volume=15 |issue=2 |pages=144–50 |date=April 2003 |pmid=12658001 |doi= |url=}}</ref><ref name="pmid7774210">{{cite journal |vauthors=Solenski NJ, Haley EC, Kassell NF, Kongable G, Germanson T, Truskowski L, Torner JC |title=Medical complications of aneurysmal subarachnoid hemorrhage: a report of the multicenter, cooperative aneurysm study. Participants of the Multicenter Cooperative Aneurysm Study |journal=Crit. Care Med. |volume=23 |issue=6 |pages=1007–17 |date=June 1995 |pmid=7774210 |doi= |url=}}</ref>
* In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
*The [[incidence]] of neurogenic [[pulmonary edema]] is approximately 20000  per 100,000 individuals in patients with [[traumatic brain injury]].<ref name="pmid9092843">{{cite journal |vauthors=Bratton SL, Davis RL |title=Acute lung injury in isolated traumatic brain injury |journal=Neurosurgery |volume=40 |issue=4 |pages=707–12; discussion 712 |date=April 1997 |pmid=9092843 |doi= |url=}}</ref>
*Age, gender, race and other [[Epidemiology|epidemiologic]] and [[Demographics|demographic]] features are based on underlying [[Neurology|neurologic]] problem. Overall [[pulmonary edema]] commonly affects individuals older than 65 years of age.
===Age===
*Patients of all age groups may develop [disease name].
*[Disease name] is more commonly observed among patients aged [age range] years old.
*[Disease name] is more commonly observed among [elderly patients/young patients/children].
===Gender===
*[Disease name] affects men and women equally.
*[Gender 1] are more commonly affected with [disease name] than [gender 2].
* The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
===Race===
*There is no racial predilection for [disease name].
*[Disease name] usually affects individuals of the [race 1] race.
*[Race 2] individuals are less likely to develop [disease name].
   
   
==Risk Factors==
==Risk Factors==
*Severe brain damage represents a risk factor for developing neurogenic pulmonary edema, which include:<ref name="pmid23917719">{{cite journal |vauthors=Ridenti FA |title=Neurogenic pulmonary edema: a current literature review |journal=Rev Bras Ter Intensiva |volume=24 |issue=1 |pages=91–6 |date=March 2012 |pmid=23917719 |doi= |url=}}</ref>
*Severe [[brain damage]] represents a risk factor for developing neurogenic [[pulmonary edema]], which include:<ref name="pmid23917719">{{cite journal |vauthors=Ridenti FA |title=Neurogenic pulmonary edema: a current literature review |journal=Rev Bras Ter Intensiva |volume=24 |issue=1 |pages=91–6 |date=March 2012 |pmid=23917719 |doi= |url=}}</ref>
**Cerebral hemorrhage
**[[Cerebral hemorrhage]]
**Subarachnoid hemorrhage
**[[Subarachnoid hemorrhage]]
**Head injuries
**[[Head injury|Head injuries]]
**Seizures
**[[Seizure|Seizures]]
   
   
== Natural History, Complications and Prognosis==
== Natural History, Complications and Prognosis==
*Misdiagnosis and inappropriate treatment may worsen cerebral damage because of hypoxemia or reduced cerebral perfusion pressure.<ref name="pmid239177192">{{cite journal |vauthors=Ridenti FA |title=Neurogenic pulmonary edema: a current literature review |journal=Rev Bras Ter Intensiva |volume=24 |issue=1 |pages=91–6 |date=March 2012 |pmid=23917719 |doi= |url=}}</ref>
*Misdiagnosis and inappropriate treatment may worsen [[Brain|cerebral]] damage because of [[hypoxemia]] or reduced [[cerebral perfusion pressure]].<ref name="pmid23917719">{{cite journal |vauthors=Ridenti FA |title=Neurogenic pulmonary edema: a current literature review |journal=Rev Bras Ter Intensiva |volume=24 |issue=1 |pages=91–6 |date=March 2012 |pmid=23917719 |doi= |url=}}</ref>
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*Common [[Complication (medicine)|complications]] of neurogenic [[pulmonary edema]] are based on underlying [[Neurology|neurological]] damage and [[pulmonary edema]] (include [[electrolyte disturbance]], leg and/or [[Abdominal distension|abdominal swelling]] and [[respiratory arrest]]).
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*[[Prognosis]] is generally poor and the associated [[mortality rate]] is high, but surviving patients usually recover very quickly.<ref name="pmid17378783">{{cite journal |vauthors=Baumann A, Audibert G, McDonnell J, Mertes PM |title=Neurogenic pulmonary edema |journal=Acta Anaesthesiol Scand |volume=51 |issue=4 |pages=447–55 |date=April 2007 |pmid=17378783 |doi=10.1111/j.1399-6576.2007.01276.x |url=}}</ref><ref name="pmid12658001">{{cite journal |vauthors=Fontes RB, Aguiar PH, Zanetti MV, Andrade F, Mandel M, Teixeira MJ |title=Acute neurogenic pulmonary edema: case reports and literature review |journal=J Neurosurg Anesthesiol |volume=15 |issue=2 |pages=144–50 |date=April 2003 |pmid=12658001 |doi= |url=}}</ref>
*Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
*Prognosis is generally poor and the associated mortality rate is high, but surviving patients usually recover very quickly.<ref name="pmid17378783">{{cite journal |vauthors=Baumann A, Audibert G, McDonnell J, Mertes PM |title=Neurogenic pulmonary edema |journal=Acta Anaesthesiol Scand |volume=51 |issue=4 |pages=447–55 |date=April 2007 |pmid=17378783 |doi=10.1111/j.1399-6576.2007.01276.x |url=}}</ref><ref name="pmid12658001">{{cite journal |vauthors=Fontes RB, Aguiar PH, Zanetti MV, Andrade F, Mandel M, Teixeira MJ |title=Acute neurogenic pulmonary edema: case reports and literature review |journal=J Neurosurg Anesthesiol |volume=15 |issue=2 |pages=144–50 |date=April 2003 |pmid=12658001 |doi= |url=}}</ref>


== Diagnosis ==
== Diagnosis ==
===Symptoms===
===Symptoms===
*NPE is characterized by dyspnea, bilateral basal pulmonary crackles and the other signs and symptoms of pulmonary edema, in the absence of cardiac failure.<ref name="pmid25820093">{{cite journal |vauthors=Tu YF, Lin CH, Lee HT, Yan JJ, Sze CI, Chou YP, Ho CJ, Huang CC |title=Elevated cerebrospinal fluid endothelin 1 associated with neurogenic pulmonary edema in children with enterovirus 71 encephalitis |journal=Int. J. Infect. Dis. |volume=34 |issue= |pages=105–11 |date=May 2015 |pmid=25820093 |doi=10.1016/j.ijid.2015.03.017 |url=}}</ref>
*NPE is characterized by [[dyspnea]], bilateral basal pulmonary [[Rales|crackles]] and the other signs and symptoms of [[pulmonary edema]], in the absence of [[Congestive heart failure|cardiac failure]].<ref name="pmid25820093">{{cite journal |vauthors=Tu YF, Lin CH, Lee HT, Yan JJ, Sze CI, Chou YP, Ho CJ, Huang CC |title=Elevated cerebrospinal fluid endothelin 1 associated with neurogenic pulmonary edema in children with enterovirus 71 encephalitis |journal=Int. J. Infect. Dis. |volume=34 |issue= |pages=105–11 |date=May 2015 |pmid=25820093 |doi=10.1016/j.ijid.2015.03.017 |url=}}</ref>
*For more information about symptoms in pulmonary edema click '''''[[Pulmonary edema|here]]'''''.
*For more information about [[Symptom|symptoms]] in [[pulmonary edema]] click '''''[[Pulmonary edema|here]]'''''.
=== Physical Examination ===
=== Physical Examination ===
*Patients with neurogenic pulmonary edema usually appear:
*Patients with neurogenic [[pulmonary edema]] usually appear:
** [[Anxious]]
** [[Anxious]]
** Decrease in level of [[consciousness]]
** Decrease in level of [[consciousness]]
*Physical examination is remarkable for the signs of underlying neurologic damage and pulmonary edema, include:
*[[Physical examination]] is remarkable for the [[Medical sign|signs]] of underlying [[Neurology|neurologic]] damage and [[pulmonary edema]], include:
** [[Wheezing]]
** [[Wheezing]]
** Prolonged expiratory phase
** Prolonged expiratory phase
Line 87: Line 69:
** Use of [[accessory muscles of respiration]]
** Use of [[accessory muscles of respiration]]
**Nasal flaring
**Nasal flaring
**Tachypnea
**[[Tachypnea]]
**Bradycardia
**[[Bradycardia]]
**High systemic blood pressure
**High systemic [[blood pressure]]
=== Laboratory Findings ===
=== Laboratory Findings ===
*There are no specific laboratory findings associated with [disease name].


*A  [positive/negative] [test name] is diagnostic of [disease name].
==== Arterial blood gas test: ====
*An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
* [[Hypoxia]]:
*Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
** [[Oxygen saturation]] < 90%
** [[PaO2]] < 60 mm Hg
 
* [[Hypercapnia]]:
** [[CO2]] > 45–55 mm Hg
 
* [[Acidosis]]:
** PH < 7.35 nEq/liter
** Early findings of [[pulmonary edema]] may be [[respiratory alkalosis]] because of [[hyperventilation]]
 
===Imaging Findings===
===Imaging Findings===
*There are no [imaging study] findings associated with [disease name].
*[[Imaging]] findings are remarkable for the [[pulmonary edema]] and underlying [[Neurology|neurologic]] damage.
*For more information about [[imaging]] findings in [[pulmonary edema]] click '''''[[Pulmonary edema|here]]'''''.
*[Imaging study 1] is the imaging modality of choice for [disease name].
*On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
*[Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
=== Other Diagnostic Studies ===
*[Disease name] may also be diagnosed using [diagnostic study name].
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
   
   
== Treatment ==
== Treatment ==
=== Medical Therapy ===
=== Medical Therapy ===
*In treatment of neurogenic pulmonary edema, the main principle is supportive treatment and decreasing intracranial pressure as in acute respiratory distress syndrome.<ref name="pmid26884694">{{cite journal |vauthors=Sarı MY, Yıldızdaş RD, Yükselmiş U, Horoz ÖÖ |title=Our patients followed up with a diagnosis of neurogenic pulmonary edema |journal=Turk Pediatri Ars |volume=50 |issue=4 |pages=241–4 |date=December 2015 |pmid=26884694 |pmc=4743867 |doi=10.5152/TurkPediatriArs.2015.1411 |url=}}</ref>
*In treatment of neurogenic [[pulmonary edema]], the main principle is supportive treatment and decreasing [[intracranial pressure]] as in [[acute respiratory distress syndrome]].<ref name="pmid26884694">{{cite journal |vauthors=Sarı MY, Yıldızdaş RD, Yükselmiş U, Horoz ÖÖ |title=Our patients followed up with a diagnosis of neurogenic pulmonary edema |journal=Turk Pediatri Ars |volume=50 |issue=4 |pages=241–4 |date=December 2015 |pmid=26884694 |pmc=4743867 |doi=10.5152/TurkPediatriArs.2015.1411 |url=}}</ref>
   
   
*The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
*For more information about medical therapy in [[pulmonary edema]] click '''''[[Pulmonary edema|here]]'''''.
*Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
   
   
=== Surgery ===
=== Surgery ===
*
*The mainstay of treatment for [[pulmonary edema]] is medical therapy. Surgery may be reserved for underlying [[Neurology|neurological]] damage.
   
   
=== Prevention ===
=== Prevention ===
*Treating the underlying neurologic disease is the only way of preventing the recurrence of pulmonary edema.<ref name="pmid6437896">{{cite journal |vauthors=Piatti L, Locatelli V, Ferracini C, Sozzi G |title=[Neurogenic pulmonary edema. Description of a case occurring after an epileptic crisis] |language=Italian |journal=G Ital Cardiol |volume=14 |issue=8 |pages=602–5 |date=August 1984 |pmid=6437896 |doi= |url=}}</ref>
*Treating the underlying [[Neurology|neurologic]] disease is the only way of [[Prevention (medical)|preventing]] the recurrence of [[pulmonary edema]].<ref name="pmid6437896">{{cite journal |vauthors=Piatti L, Locatelli V, Ferracini C, Sozzi G |title=[Neurogenic pulmonary edema. Description of a case occurring after an epileptic crisis] |language=Italian |journal=G Ital Cardiol |volume=14 |issue=8 |pages=602–5 |date=August 1984 |pmid=6437896 |doi= |url=}}</ref>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
   
   
[[Category:Pick One of 28 Approved]]
[[Category:Medicine]]
[[Category:Up-To-Date]]
[[Category:Pulmonology]]


{{WS}}
{{WS}}
{{WH}}
{{WH}}

Latest revision as of 18:28, 26 March 2018

WikiDoc Resources for Neurogenic pulmonary edema

Articles

Most recent articles on Neurogenic pulmonary edema

Most cited articles on Neurogenic pulmonary edema

Review articles on Neurogenic pulmonary edema

Articles on Neurogenic pulmonary edema in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Neurogenic pulmonary edema

Images of Neurogenic pulmonary edema

Photos of Neurogenic pulmonary edema

Podcasts & MP3s on Neurogenic pulmonary edema

Videos on Neurogenic pulmonary edema

Evidence Based Medicine

Cochrane Collaboration on Neurogenic pulmonary edema

Bandolier on Neurogenic pulmonary edema

TRIP on Neurogenic pulmonary edema

Clinical Trials

Ongoing Trials on Neurogenic pulmonary edema at Clinical Trials.gov

Trial results on Neurogenic pulmonary edema

Clinical Trials on Neurogenic pulmonary edema at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Neurogenic pulmonary edema

NICE Guidance on Neurogenic pulmonary edema

NHS PRODIGY Guidance

FDA on Neurogenic pulmonary edema

CDC on Neurogenic pulmonary edema

Books

Books on Neurogenic pulmonary edema

News

Neurogenic pulmonary edema in the news

Be alerted to news on Neurogenic pulmonary edema

News trends on Neurogenic pulmonary edema

Commentary

Blogs on Neurogenic pulmonary edema

Definitions

Definitions of Neurogenic pulmonary edema

Patient Resources / Community

Patient resources on Neurogenic pulmonary edema

Discussion groups on Neurogenic pulmonary edema

Patient Handouts on Neurogenic pulmonary edema

Directions to Hospitals Treating Neurogenic pulmonary edema

Risk calculators and risk factors for Neurogenic pulmonary edema

Healthcare Provider Resources

Symptoms of Neurogenic pulmonary edema

Causes & Risk Factors for Neurogenic pulmonary edema

Diagnostic studies for Neurogenic pulmonary edema

Treatment of Neurogenic pulmonary edema

Continuing Medical Education (CME)

CME Programs on Neurogenic pulmonary edema

International

Neurogenic pulmonary edema en Espanol

Neurogenic pulmonary edema en Francais

Business

Neurogenic pulmonary edema in the Marketplace

Patents on Neurogenic pulmonary edema

Experimental / Informatics

List of terms related to Neurogenic pulmonary edema

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]

Overview

Neurogenic pulmonary edema usually appears within minutes to hours after a cerebral injury. It is an acute life-threatening complication associated with many forms of central nervous system injury, such as brain or spinal cord hemorrhage, trauma, tumors, epilepsy and infections. The pathogenetic factors for the its onset include increased intracranial pressure and severe over-activation of the sympathetic nervous system. Neurogenic pulmonary edema must be differentiated from other diseases with same symptoms, include aspiration pneumonia, cardiogenic pulmonary edema, angioedema and asthma attack. NPE is characterized by dyspnea, bilateral basal pulmonary crackles and the other signs and symptoms of pulmonary edema, in the absence of cardiac failure. Arterial blood gas test shows hypoxemia, hypercapnia and acidosis. In treatment of neurogenic pulmonary edema, the main principle is supportive treatment and decreasing intracranial pressure as in acute respiratory distress syndrome.

Historical Perspective

Pathophysiology

Differentiating neurogenic pulmonary edema from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Symptoms

Physical Examination

Laboratory Findings

Arterial blood gas test:

Imaging Findings

Treatment

Medical Therapy

Surgery

Prevention

References

  1. ↑ Davison DL, Terek M, Chawla LS (December 2012). "Neurogenic pulmonary edema". Crit Care. 16 (2): 212. doi:10.1186/cc11226. PMC 3681357. PMID 22429697.
  2. ↑ Izumida H, Homma K, Sasaki J, Hori S (April 2017). "Pulmonary edema following tonic-clonic seizure". Acute Med Surg. 4 (2): 221–222. doi:10.1002/ams2.251. PMC 5667274. PMID 29123866.
  3. ↑ Simmons RL, Heisterkamp CA, Collins JA, Genslar S, Martin AM (July 1969). "Respiratory insufficiency in combat casualties. 3. Arterial hypoxemia after wounding". Ann. Surg. 170 (1): 45–52. PMC 1387602. PMID 5789529.
  4. ↑ Smith WS, Matthay MA (May 1997). "Evidence for a hydrostatic mechanism in human neurogenic pulmonary edema". Chest. 111 (5): 1326–33. PMID 9149590.
  5. ↑ 5.0 5.1 Kim JE, Park JH, Lee SH, Lee Y (October 2012). "Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report-". Korean J Anesthesiol. 63 (4): 368–71. doi:10.4097/kjae.2012.63.4.368. PMC 3483499. PMID 23115693.
  6. ↑ Kim JE, Park JH, Lee SH, Lee Y (October 2012). "Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report-". Korean J Anesthesiol. 63 (4): 368–71. doi:10.4097/kjae.2012.63.4.368. PMC 3483499. PMID 23115693.
  7. ↑ Šedý J, Kuneš J, Zicha J (August 2015). "Pathogenetic Mechanisms of Neurogenic Pulmonary Edema". J. Neurotrauma. 32 (15): 1135–45. doi:10.1089/neu.2014.3609. PMID 25496372.
  8. ↑ Piatti L, Locatelli V, Ferracini C, Sozzi G (August 1984). "[Neurogenic pulmonary edema. Description of a case occurring after an epileptic crisis]". G Ital Cardiol (in Italian). 14 (8): 602–5. PMID 6437896.
  9. ↑ Pender ES, Pollack CV (1992). "Neurogenic pulmonary edema: case reports and review". J Emerg Med. 10 (1): 45–51. PMID 1629591.
  10. ↑ Fontes RB, Aguiar PH, Zanetti MV, Andrade F, Mandel M, Teixeira MJ (April 2003). "Acute neurogenic pulmonary edema: case reports and literature review". J Neurosurg Anesthesiol. 15 (2): 144–50. PMID 12658001.
  11. ↑ Solenski NJ, Haley EC, Kassell NF, Kongable G, Germanson T, Truskowski L, Torner JC (June 1995). "Medical complications of aneurysmal subarachnoid hemorrhage: a report of the multicenter, cooperative aneurysm study. Participants of the Multicenter Cooperative Aneurysm Study". Crit. Care Med. 23 (6): 1007–17. PMID 7774210.
  12. ↑ Bratton SL, Davis RL (April 1997). "Acute lung injury in isolated traumatic brain injury". Neurosurgery. 40 (4): 707–12, discussion 712. PMID 9092843.
  13. ↑ 13.0 13.1 Ridenti FA (March 2012). "Neurogenic pulmonary edema: a current literature review". Rev Bras Ter Intensiva. 24 (1): 91–6. PMID 23917719.
  14. ↑ Baumann A, Audibert G, McDonnell J, Mertes PM (April 2007). "Neurogenic pulmonary edema". Acta Anaesthesiol Scand. 51 (4): 447–55. doi:10.1111/j.1399-6576.2007.01276.x. PMID 17378783.
  15. ↑ Fontes RB, Aguiar PH, Zanetti MV, Andrade F, Mandel M, Teixeira MJ (April 2003). "Acute neurogenic pulmonary edema: case reports and literature review". J Neurosurg Anesthesiol. 15 (2): 144–50. PMID 12658001.
  16. ↑ Tu YF, Lin CH, Lee HT, Yan JJ, Sze CI, Chou YP, Ho CJ, Huang CC (May 2015). "Elevated cerebrospinal fluid endothelin 1 associated with neurogenic pulmonary edema in children with enterovirus 71 encephalitis". Int. J. Infect. Dis. 34: 105–11. doi:10.1016/j.ijid.2015.03.017. PMID 25820093.
  17. ↑ Sarı MY, Yıldızdaş RD, Yükselmiş U, Horoz ÖÖ (December 2015). "Our patients followed up with a diagnosis of neurogenic pulmonary edema". Turk Pediatri Ars. 50 (4): 241–4. doi:10.5152/TurkPediatriArs.2015.1411. PMC 4743867. PMID 26884694.
  18. ↑ Piatti L, Locatelli V, Ferracini C, Sozzi G (August 1984). "[Neurogenic pulmonary edema. Description of a case occurring after an epileptic crisis]". G Ital Cardiol (in Italian). 14 (8): 602–5. PMID 6437896.

Template:WS Template:WH

Retrieved from "https://www.wikidoc.org/index.php?title=Neurogenic_pulmonary_edema&oldid=1456601"