Brief description of the disease
Pulmonary edema - a serious, often fatal complication of a number of cardiovascular diseases associated with bleeding of serous-hemorrhagic fluid in the alveoli of the lungs.
There membranogenny hydrostatic pulmonary edema, which differ in origin.
Depending on the disease, leading to edema, can be identified and cardiac toxic pulmonary edema.
The main causes of pulmonary edema - stagnation in the pulmonary circulation or toxic destruction of blood vessels of the lungs. Often swelling occurs under the same diseases as asthma: atherosclerotic cardiosclerosis, heart disease, myocardial infarction, hypertension (cardiac edema). In these cases, swelling is the most severe form of cardiac asthma.
The cause of toxic pulmonary edema - a poisoning barbiturates, alcohol, poisons, nitrogen oxides, metal carbonyls, arsenic, as well as burns, diabetic and hepatic coma, uremia.
The cause pulmonary edema membranogennogo - initial increase in pulmonary capillary permeability that occurs in various diseases.
The cause of hydrostatic pulmonary edema - an increase vnutrikapillyarnogo hydrostatic pressure of the blood to 7-10mm.rt.st., Causing the output of the liquid portion of the blood in excessive amounts, which lead through the lymphatic way possible.
Symptoms of pulmonary edema, diagnostics
Since the attack develops rapidly, its diagnosis is happening on stage examination, based on the symptoms observed. It is important to quickly understand the situation, to provide emergency assistance in pulmonary edema, begin therapy to prevent recurrent attacks, or a person can die within a few minutes of asphyxiation.
Disease develops suddenly, at night, when the patient is asleep or in the afternoon when he feels the excitement or making physical effort. Often the initial symptoms of pulmonary edema expressed in frequent coughing, build-up in the lungs moist rales, changing the color of the face. The patient feels a strong choking, crushing pain, tightness in the chest, his breathing quickens sharply, and even from a distance hear bubbling wheeze. All quickens cough is accompanied by copious frothy sputum pink or light. If the condition is very severe, the foam can go and nose. These symptoms are added hindered inhale and exhale, jugular vein, cold clammy sweat, cyanosis of the skin.
As soon as the attack develops, when listening to the lungs determined variegated moist rales over different parts of the lungs, breathing in these areas either weakened or non-existent. If, during the attack to carry out X-ray characteristic symptoms of pulmonary edema are the roots of their extended, large focal shadows with fuzzy contours (the transparency of the lung fields reduced).
There has also been a sharp increase in pulse rate, often to 140-160 beats / minute, sometimes there is a sudden bradycardia.
Blood pressure is not an important symptom of pulmonary edema - it depends on the initial level (before the attack), and may be different.
Common symptoms of toxic origin complemented edema symptoms of the underlying disease or a destructive process: burn disease, coma, damage to the upper respiratory tract, etc.
Treatment of pulmonary edema
It is important to conduct a full-fledged therapy to provide emergency assistance in pulmonary edema:
- ensure that the person whose attack was in a semi-sitting or sitting position.
- From the upper airway suctioned.
- If the increased pressure to conduct bloodletting: 200-300ml adults, children 100-200ml.
- Alcohol vapor inhalation conduct. For children use 30% alcohol, for adults - 70%.
- Tourniquet on his feet for half an hour or an hour.
- Enter subcutaneously 2ml 20% camphor solution.
- Conduct oxygen therapy (introduction of oxygen into the airways via oxygen oxygen mask).
In inpatient acute care in pulmonary edema is the introduction of cardiac glycosides, carrying bleeding if it is not carried out before (under reduced pressure, collapse, heart bled contraindicated), continuing oxygen therapy, administration of Lasix or Novurita.
After the emergency and stabilization of a partner are treated with pulmonary edema, which should be aimed at reducing or eliminating activities attack the causes. By reducing the flow of blood to the lungs (cupping, harnesses, diuretics), prescribe drugs to facilitate the work of the heart, reduces peripheral vascular resistance, improving the process of exchange in the myocardium.
Also in the treatment of pulmonary edema, a number of activities designed to seal the capillary-alveolar membrane, a constant supply of oxygen. It is important to improve the emotional state of the patient, take him out of the stress that often triggers an attack. To this end, as a treatment for pulmonary edema is successfully used sedatives. In addition to the overall calming effect these tools reduce vascular spasm, blood flow to the lungs, facilitate the work of the heart, reduce shortness of breath, fluid tissue penetration through the capillary-alveolar membrane, reduce the intensity of metabolic processes (which makes it easier to move the lack of oxygen).
Often such a sedative, has long been used successfully in the treatment of pulmonary edema, a morphine. Its 1% solution is administered intravenously in a volume of 1-1 5ml. In some cases, it allows to eliminate edema.
Prevention of disease
Warning attack is a timely treatment of conditions and diseases that can provoke an attack, in compliance with the rules of safety at work with harmful toxic substances.