CARDIOGENIC PULMONARY EDEMA IN CRITICAL CARE

FAHAD BAHAIDARAH *

Emergancy Medicine and Pre-hospital Medicine, King Abdulaziz Medical City -Jeddah, Saudi Arabia.

ABDULLAH SAUD ALSHAMMARI

King Salman Specialized Hospital (KSSH), Hail, Saudi Arabia.

ABDULAZIZ AYED ALSHAMMARI

King Salman Specialized Hospital (KSSH), Hail, Saudi Arabia.

OSAMA MOHAMMED JABBARI

Abu Arish general hospital, Jazan, Saudi Arabia.

ABDULELAH DULAYM ALSUHAYMI

Buraydah Central Hospital, Buraydah, Qassim, Saudi Arabia.

FATIMA HUMADAN AL-OJAFI

Nursing Public Health, Saudi Arabia.

RASHED ABDULAZIZ BOSHUSHAH

King Fahad Hospital Al-Hofuf, Saudi Arabia.

MOHAMMED DREES ALHERZ

King Fahad Hospital Hofouf, Alahsaa, Saudi Arabia.

ABDULLAH SAAD ALSHALAWI

Erada Complex and Mental Health, Dammam, Saudi Arabia.

OMAR MOHAMMED ALGHAMDI

Dammam Medical Complex, Dammam, Saudi Arabia.

AHMED SAAD ALZAHRANI

King Abdulaziz Medical City in Jeddah (NGHA), Jeddah, Saudi Arabia.

H. AL ZARA, JAWAD MUBARAK

Safwa General Hospital (SGH), Safwa, Ras Tanura, Saudi Arabia.

Y. BARNAWI, ENAS MOHAMMED

King Abdulaziz Hospital in Makkah, Saudi Arabia.

*Author to whom correspondence should be addressed.


Abstract

The pathobiology and classification of pulmonary edoema are more complex than the previous dichotomy of hydrostatic vs. permeability. The mechanisms of alveolar fluid clearance and the factors that influence the clearance rate are being studied thoroughly in order to develop therapeutic strategies. Patients require early oxygenation and ventilation stabilization, preferably with high-flow nasal cannula oxygen or noninvasive ventilation, while the diagnostic cause is quickly sought with echocardiography and other testing. Treatments must begin as soon as possible while evaluation continues and requires multimodal intervention. Diuretics, possibly morphine, and frequently nitrates, are used to treat cardiogenic pulmonary edema. This review summarizes current knowledge of the pathophysiology, causes, and treatment of cardiogenic pulmonary edema.

Keywords: Pulmonary edema, heart, edema, CPE, echocardiography, cardiogenic pulmonary edema


How to Cite

BAHAIDARAH, F., ALSHAMMARI, A. S., ALSHAMMARI, A. A., JABBARI, O. M., ALSUHAYMI, A. D., AL-OJAFI, F. H., BOSHUSHAH, R. A., ALHERZ, M. D., ALSHALAWI, A. S., ALGHAMDI, O. M., ALZAHRANI, A. S., MUBARAK, H. A. Z. J., & MOHAMMED, Y. B. E. (2022). CARDIOGENIC PULMONARY EDEMA IN CRITICAL CARE. UTTAR PRADESH JOURNAL OF ZOOLOGY, 43(24), 152–163. https://doi.org/10.56557/upjoz/2022/v43i243309

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References

Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: diagnosis and management. Am Fam Physician. 2013 Jul 15;88(2):102- 10.

Murray JF. Pulmonary edema: pathophysiology and diagnosis. Int J Tuberc Lung Dis. 2011 Feb;15(2):155-60, i.

Dobbe L, Rahman R, Elmassry M, Paz P, Nugent K. Cardiogenic pulmonary edema. Am J Med Sci. 2019 Dec;358(6):389-397.

DOI: 10.1016/j.amjms.2019.09.011. Epub 2019 Oct 1. PMID: 31813466.

Roussos C, Macklem PT. The respiratory muscles. N Engl J Med. 1982;307:786–97.

Pingleton SK. Complications of acute respiratory failure. Am Rev Respir Dis. 1988; 137:1463–93.

L'Her E, Millet E, Duquesne F. Oedème pulmonaire cardiogénique de la personne âgée [Cardiogenic pulmonary edema in the elderly]. Rev Prat. 2003 May 1;53(9):958-61. French. PMID: 12816033.

Sharp JT, Griffith GT, Bunnell IL, et al. Ventilatory mechanics in pulmonary edema in man. J Clin Invest. 1958;37:111-7.

DOI:10.1172/JCI103577

Aubier M, Trippenbach T, Roussos C. Respiratory muscle fatigue during cardiogenic shock. J Appl Physiol. 1981;51:499-508.

DOI:10.1152/jappl.1981.51.2.499

Field S, Kelly SM, Macklem PT. The oxygen cost of breathing in patients with cardiorespiratory disease. Am Rev Respir Dis. 1982;126:9-13.

Katz JA, Marks JD. Inspiratory work with and without continuous positive airway pressure in patients with acute respiratory failure. Anesthesiology. 1985;63:598-607.

DOI:10.1097/00000542-198512000-00008

Petrof BJ, Legere M, Goldberg P, et al. Continuous positive airway pressure reduced work of breathing and dyspnea during weaning from mechanical ventilation in severe chronic obstructive pulmonary disease. Am Rev Respir Dis. 1990;141:281-9.

DOI:10.1164/ajrccm/141.2.281

Dickstein K, Cohen-Solal A, Filippatos G, et al. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM) Eur Heart J. 2008;2008;29:2388— 2442. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology.

Sureka B, Bansal K, Arora A. Pulmonary edema - cardiogenic or noncardiogenic? J Family Med Prim Care. 2015 Apr-Jun;4(2):290.

Alwi I. Diagnosis and management of cardiogenic pulmonary edema. Acta Med Indones. 2010 Jul;42(3):176-84.

Komiya K, Ishii H, Murakami J, et al. Comparison of chest computed tomography features in the acute phase of cardiogenic pulmonary edema and acute respiratory distress syndrome on arrival at the emergency department. J Thorac Imaging. 2013 Sep. 28(5):322-8.

Bhatia SK. Biomaterials for clinical applications (Online-Ausg. ed.). New York: Springer. 2010;23.

ISBN 9781441969200. Archived from the original on 10 January 2017.

"Myocardial ischemia - Symptoms and causes". Mayo Clinic. Retrieved 5 February 2022.

"Coronary Artery Disease (CAD)". 12 March 2013. Archived from the original on 2 March 2015. Retrieved 23 February 2015.

Mendis S, Puska P, Norrving B, eds. Global atlas on cardiovascular disease prevention and control. World Health Organization. 2011;3–18.

hdl:10665/44701. ISBN 978-92-4-156437-3.

"Ischemic Heart Disease". National Heart, Lung, and Blood Institute (NHLBI). Retrieved 2 February 2019.

Murray, Christopher JL. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. January 2015;385 (9963):117–71.

DOI:10.1016/S0140-6736(14)61682-2 PMC4340604. PMID 25530442.

Wong ND. Epidemiological studies of CHD and the evolution of preventive cardiology. Nature Reviews. Cardiology. May 2014; 11(5):276–89.

DOI:10.1038/nrcardio.2014.26. PMID 24663092. S2CID 9327889.

National Clinical Guideline Centre (UK). Chronic heart failure: National clinical guideline for diagnosis and management in primary and secondary care: Partial update. National Clinical Guideline Centre. August 2010;19–24. PMID 22741186.

McDonagh TA. Oxford textbook of heart failure. Oxford: Oxford University Press. 2011;3.

ISBN 978-0-19-957772-9.

"What Are the Signs and Symptoms of Coronary Heart Disease?". 29 September 2014. Archived from the original on 24 February 2015.

Retrieved 23 February 2015.

"Coronary Artery Disease (CAD)". 12 March 2013. Archived from the original on 2 March 2015. Retrieved 23 February 2015.

Carlisi M, Mancuso S, Lo Presti R, Siragusa S, Caimi G. High output heart failure in multiple myeloma: Pathogenetic considerations. Cancers (Basel). January 2022;14(3):610.

DOI:10.3390/cancers14030610. PMC 8833382. PMID 35158878.

McMurray JJ, Pfeffer MA. Heart failure. Lancet. 2005;365(9474):1877–89.

DOI:10.1016/S0140-6736(05)66621-4. PMID 15924986. S2CID 38678826.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27): 2129—2200.

DOI:10.1093/eurheartj/ehw128. PMID 27206819.

National Guideline Centre (UK). Chronic Heart Failure in Adults: Diagnosis and Management". National Institute for Health and Care Excellence: Clinical Guidelines; 2018.

PMID 30645061.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, et al. ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128(16):e240-327.

DOI:10.1161/CIR.0b013e31829e8776.

PMID 23741058.

National Clinical Guideline Centre (UK). Chronic heart failure: National clinical guideline for diagnosis and management in primary and secondary care: Partial update. National Clinical Guideline Centre. August 2010;19—24. PMID 22741186.

"What is Heart Failure?"

Available:www.heart.org

Retrieved 11 August 2022.

Maron BJ, Towbin JA, Thiene G, et al. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation. 2006;113(14):1807–1816.

Institute of Medicine (US) Committee on Social Security Cardiovascular Disability Criteria. Cardiovascular Disability: Updating the Social Security Listings. Washington (DC): National Academies Press (US). 2010;12.

Murray JF. Pulmonary edema: pathophysiology and diagnosis. Int J Tuberc Lung Dis. 2011 Feb;15(2):155-60, i.

Billon C, Brambilla C, Paramelle B. Les shunts droite-gauche de l'adulte [Right to left shunts in the adult]. Rev Mal Respir. 1994;11(3):229-38. French. PMID: 8041986.

Ware LB, Matthay MA. Clinical practice. Acute pulmonary edema. N. Engl. J. Med. December 2005;353 (26):2788–96.

DOI:10.1056/NEJMcp052699. PMID 16382065.

Assaad S, Kratzert WB, Shelley B, Friedman MB, Perrino A. Assessment of pulmonary edema: Principles and practice. J Cardiothorac Vasc Anesth. 2018 Apr;32(2):901-914

Ware LB, Matthay MA. Clinical practice. Acute pulmonary edema. N Engl J Med. 2005 Dec 29;353(26):2788-96.

What Is Arrhythmia?". National Heart, Lung, and Blood Institute. July 1, 2011. Archived from the original on 2 March 2015. Retrieved 7 March 2015.

Chioncel O, Collins SP, Ambrosy AP, Gheorghiade M, Filippatos G. Pulmonary Oedema-Therapeutic Targets. Card Fail Rev. 2015 Apr;1(1):38-45.

Bonilla-Palomas JL, Gámez-López AL, Moreno-Conde M, López-Ibáñez MC, Anguita-Sánchez M, Gallego de la Sacristana A, García-Catalán F, Villar-Ráez A. Hypoalbuminemia in acute heart failure patients: causes and its impact on hospital and long-term mortality. J Card Fail. 2014 May;20(5):350-8.

Taylor AE. Capillary fluid filtration. Starling forces and lymph flow. Circ Res. 1981 Sep;49(3):557-75.

MacIntyre, Neil R. Supporting oxygenation in acute respiratory failure. Respiratory Care. 2013;1 (58): 142–150.

DOI:10.4187/respcare.02087.

PMID 23271824.

"Pulmonary Edema: Symptoms, Causes, and Treatment". Healthline. 13 May 2014. Archived from the original on 28 April 2022.

Cleland JG, Yassin AS, Khadjooi K. Acute heart failure: focusing on acute cardiogenic pulmonary oedema. Clin Med. 2010;10(1):59–64.

DOI:10.7861/clinmedicine.10-1-59

PMC 4954483. PMID 20408310.

Wang Y, Brown J, Godfrey C, Ahmad M, Vital FMR, Lambiase P, Banerjee A, Bakhai A, Chong M. Non‐invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane Database of Systematic Reviews. 2019;4:CD005351.

DOI:10.1002/14651858.CD005351.pub4. PMC 6449889. PMID 30950507.

McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Køber L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A, Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, McDonagh T, Sechtem U, Bonet LA, Avraamides P, Ben Lamin HA, Brignole M, Coca A, Cowburn P, Dargie H, Elliott P, Flachskampf FA, Guida GF, Hardman S, Iung B, Merkely B, Mueller C, Nanas JN, Nielsen OW, Orn S, Parissis JT, Ponikowski P. ESC Committee for Practice Guidelines. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012 Aug;14(8):803-69.

Publication Committee for the VMAC Investigators (Vasodilatation in the Management of Acute CHF). Intravenous nesiritide vs nitroglycerin for treatment of decompensated congestive heart failure: a randomized controlled trial. JAMA. 2002 Mar 27;287(12):1531-40.

Bärtsch P, Maggiorini M, Ritter M, Noti C, Vock P, Oelz O. Prevention of high-altitude pulmonary edema by nifedipine. N Engl J Med. 1991 Oct 31;325(18):1284-9.

Cuffe MS, Califf RM, Adams KF, Benza R, Bourge R, Colucci WS, Massie BM, O'Connor CM, Pina I, Quigg R, Silver MA, Gheorghiade M, Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Investigators. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002 Mar 27;287(12):1541-7.