Pulmonary edema is a life-threatening, very serious and acute painful condition associated with abnormal accumulation of interstitial fluid in the lung tissue and inside the alveoli. Thus, instead of the air that must enter the pulmonary vesicles, water enters them, and because of this, a person does not have the ability to breathe, literally choking and dying.
Alveolar pulmonary edema is already a late stage when fluid that has seeped through the capillary wall into the area between tissue cells is in the pulmonary alveoli. Under conditions against which the alveolar vesicles are filled with liquid, the person’s breathing activity is interrupted, due to which oxygen does not fill the lungs and the body dies.
So, we will figure out what the temperature and rapid breathing in the patient are talking about.
Description of the disease
Against the background of alveolar pulmonary edema, frequent noisy breathing is added to the clinical picture along with coarse moist rales heard from a distance. A patient develops a cough with a discharge of pink, serous sputum. It happens that it becomes hard to breathe lying on your back. In the patient's lungs, against the background of weakened breathing, the number of wet rales rapidly increases. The nature of breathing with alveolar pulmonary edema is difficult to confuse with something.
Wheezing may initially be present in the lower posterior part of the lungs, then they gradually spread over the entire surface of the organ. Heart sounds against the background of all this become more deaf. In this case, the protodiastolic gallop rhythm can be heard. Blood pressure, as a rule, drops sharply. The pulse on the radial artery is present quickened, and sometimes arrhythmic.
Unlike cardiac asthma
Often, the clinical picture of pulmonary edema (according to ICD 10 - J81) does not make it possible to strictly distinguish it from an attack of cardiac asthma. True, the rapid cessation of suffocation after the elimination of pain and the use of several pills "Nitroglycerin" indicates the presence of cardiac asthma. Alveolar edema is directly characterized by paroxysmal asphyxiation, the appearance in the lower parts of the lungs of moist and finely bubbling rash.
Next, we proceed to consider the symptoms that are observed in patients in the event of alveolar edema.
Symptomatology
The clinical symptoms of such a pathology as alveolar pulmonary edema are the following manifestations:
- The appearance of pronounced suffocation, and, in addition, coughing with the release of an excessive amount of foamy sputum with blood impurities.
- The presence of bubbling breath. In this case, even at a distance moist rales can be heard. In addition, a cyanotic face is noted along with swollen neck veins and cold sweat.
- The pulse against the background of the described pathology in the patient is frequent, weak and arrhythmic, and blood pressure is lowered, and heart sounds are deaf.
- In the lungs, rales of different sizes can be heard over the entire surface.
Now we will understand the reasons that provoke the appearance in humans of such a pathology as alveolar pulmonary edema.
Causes
The causes of this edema may be the following factors:
- Diseases that are accompanied by the release of endogenous toxins, and, in addition, pneumonia.
- Overdose of drugs (especially such as "Fentanyl" and "Apressin").
- Radiation damage.
- Taking drugs in the form of heroin or cocaine. The fact is that toxins violate the integrity of the alveolocapillary membranes, because of which their permeability increases, and the capillary fluid enters the extravascular region.
- The presence of heart disease in the decompensation stage, which is accompanied by left ventricular failure and blood stasis.
What other causes of alveolar pulmonary edema are known? A disease can develop:
- Against the background of pulmonary diseases, which lead to stagnation in the region of the right circle of blood circulation. For example, this can happen with bronchial asthma and emphysema.
- With thromboembolism of the pulmonary arteries. This is especially true for people who are prone to blood clots, that is, those patients who suffer from varicose veins or hypertension.
- Against the background of diseases accompanied by a decrease in the amount of protein in the blood, for example, with cirrhosis of the liver, pathologies of the kidneys with nephrotic syndrome and the like. Against the background of these conditions, people have reduced oncotic blood pressure, which can cause pulmonary edema.
- As a result of intravenous infusions of excessive volumes of solutions without forced diuresis. This can lead to increased hydrostatic blood pressure and the development of edema.
- Often there is pulmonary edema in the elderly.
Diagnostics
As part of the diagnosis of pulmonary edema (according to ICD 10 - J81), the following procedures are performed:
- Conducting an electrocardiogram.
- Performing an x-ray with alveolar pulmonary edema.
How to deal with this pathology?
Pulmonary edema is a condition that carries an extreme threat to human life. This pathological process often ends with the death of the patient, therefore, with the initial manifestation of respiratory distress, especially against the background of a cardiac or pulmonary disease, the patient needs to call an emergency or mobile resuscitation without any delay. Next, we find out what exactly is the provision of emergency care in the event of this pathology, and find out what the procedure for conducting cardiopulmonary resuscitation is.
Urgent Care
The first measures that are taken by relatives, colleagues, friends and passers-by with pulmonary edema before the arrival of doctors should be as follows:
- In the event that a person has not lost consciousness, then it must be carefully planted so that the upper body takes a vertical position.
- It is necessary to open the windows and windows so that more oxygen enters the room.
- It is necessary to unfasten all items of clothing that press on the chest and pull the stomach.
- Give the patient to dissolve the tablet "Nitroglycerin", which is placed under the tongue. Also give "Furosemide" to remove excess fluid from the swelling tissue.
- A person needs to be able to breathe through alcohol vapor in order to extinguish foamy discharge. In a home or office, you should soak gauze with alcohol and let the patient breathe through it.
It should be borne in mind that Nitroglycerin causes a sharp drop in pressure and loss of consciousness, which can aggravate the situation. Therefore, this medication is given only under the condition of constant monitoring of blood pressure. It is better to use a sublingual spray, for example, Nitrospray or Nitromint, which are more effective in emergency situations.
The procedure for cardiopulmonary resuscitation should be strictly observed.
Now we turn to the consideration of the main treatment methods that are used by doctors in the event of a patient having this ailment.
Hospital treatment
Qualified specialists take the following measures:
- It provides saturation of the lungs with oxygen. In addition, oxygen inhalations are carried out through an alcohol solution. In this case, cannulas are introduced into the nasal passages to destroy foaming. In especially dangerous situations, tracheal intubation is done, forced ventilation of the lungs.
- Morphine hydrochloride is injected intravenously (5 milligrams), and, if necessary, after twenty minutes the procedure is repeated. Morphine eliminates nervous excitement and stops the fear of death. In addition, this drug eliminates the manifestation of shortness of breath, expanding the vessels of the brain, heart and lungs. In addition, this substance reduces pressure in the central pulmonary artery. Opiate is not used in the presence of low blood pressure and obvious respiratory distress. In the event that the patient’s breathing is depressed, a morphine antagonist in the form of “Naloxone” is prescribed.
- A softly pressing tourniquet is applied to the upper thighs. At the same time, it is important to control so that the pulse is felt. The tourniquet is removed after twenty minutes. This is necessary in order to reduce the flow of blood to the heart and reduce pressure.
- Caution should be taken to use Nitroglycerin in patients with symptoms of myocardial ischemia and in the presence of high blood pressure. When using "Nitroglycerin", the patient is first given 0.5 milligrams under the tongue. It is important to moisten the mouth with water first, as the mucous membrane dries up during edema. After this, the drug is slowly injected into the vein through a dropper no faster than 15 micrograms per minute, then the dose is gradually increased. All activities are subject to constant pressure monitoring. Do not allow pressure drops below 100.
- Against the background of the development of cardiogenic shock, Dobutamine is used intravenously, which increases the volume of cardiac output. This drug also enhances the contraction of the heart muscle, increasing blood pressure to normal values. The presented medication is endowed with a useful, and at the same time, specific property: along with the stimulation of myocardial contractions, thanks to it, the vessels of the heart, kidneys, brain, intestines expand, and, in addition, the blood circulation in them improves. "Dobutamine" is administered through a dropper at 175 micrograms per minute with a delayed increase in dosage to 300.
- Mandatory diuretic therapy is performed to increase diuresis, thereby reducing congestion in the lungs of venous blood. In addition, due to this, capacitive vessels expand, and the load on the heart is reduced. Intravenously, at a dosage of 60 milligrams, "Furosemide" is prescribed.
- In the presence of a strong and rapid heartbeat, cardiac glycosides are used. But they are not used against the background of acute heart attack, within the narrowing of the atrioventricular opening, but, in addition, if the patient has high blood pressure, since these drugs can cause a backlash, leading to aggravation of alveolar edema. In this regard, the worse the condition of the heart muscle, the more carefully cardiac glycosides should be used.
- In the event that paroxysmal rhythm disturbance in the form of ventricular tachycardia is observed with edema, eclectic impulse therapy is urgently used.
- In the event that bronchospasm occurs during edema, Eufillin is administered to patients, as well as hormonal agents in the form of Prednisolone or Dexamethasone.
Additional treatment measures
Additionally and without fail, such tools are used as:
- If there is a small amount of protein in the blood, Albumin is infused intravenously.
- Against the background of symptoms of obstruction of the pulmonary and coronary arteries with a blood clot, Heparin is used along with Pentoxifylline, which thin the blood and prevent platelets from sticking to clots. That is, due to this, aggregation is excluded.
- In the presence of bradycardia, a drug called Atropine is often used.
Bloodletting up to 500 milliliters has not been used in medical practice for a long time, but this method is very effective and may be the only salvation in difficult circumstances in which other medical opportunities will be useless.
Standard medical treatment is the main guarantee of salvation of a patient in the event of alveolar edema. But in addition to this, as part of a comprehensive treatment, you can turn to alternative methods.
What is the prognosis for pulmonary edema?
The prognosis is affected by the type of edema, severity, concomitant ailments, as well as how quickly and efficiently the person received medical care. The most unfavorable prognosis is characterized by toxic pulmonary edema, which is caused by an overdose of drugs, inhalation of poisons or toxic fumes. The highest mortality rate is observed with this form of edema.
Consider folk remedies for cough and the most effective recipes.
Folk remedies
In folk medicine, there are many tools that can help the patient in the presence of alveolar edema, both in the framework of prevention, and for the treatment of such a dangerous disease. Alternative methods can be used to prepare expectorant decoctions of aniseed seeds on honey. Such a medicine can be prepared as follows: three tablespoons are poured with a glass of honey and boiled for fifteen minutes, then half a spoonful of soda is added to the finished mixture.
Cough remedies can be very effective. The most effective recipes are given below.
Another folk remedy, which is recommended for pulmonary edema, is a decoction of flaxseeds. In order to cook it with a liter of water, pour four tablespoons of flax seeds, boil them, remove from heat and let it brew in some kind of warm place. Next, the resulting product is filtered and taken half a glass six times a day every two hours.
At present, ancient therapies are increasingly recalled in the treatment of patients, which can be extremely difficult to help. As part of this, old recipes are often recalled. One of them in the treatment of alveolar pulmonary edema is a decoction of the roots of cyanosis. To prepare the broth, pour one spoonful of cyanosis with 0.5 liters of water and keep it in a boiling water bath for forty minutes. Take the resulting medicine at 70 milliliters four times after a meal.
To prevent pulmonary edema in the elderly, namely in bed patients, they must be turned several times a day without fail from one side to the other if there are no contraindications.