Pulmonary edema is a life-threatening, very severe and acute painful condition associated with an abnormal accumulation of interstitial fluid in the lung tissue and within the alveoli. Thus, instead of air, which should penetrate into the pulmonary vesicles, water enters them, and because of this, a person does not have the opportunity to breathe, literally choking and dying.
Alveolar pulmonary edema is already a late stage, when fluid that has leaked through the capillary wall into the area between tissue cells ends up in the pulmonary alveoli. Under conditions against which the alveolar vesicles fill with liquid, the act of breathing in a person is interrupted, due to which oxygen does not fill the lungs and the body dies.
So, let's figure out what the patient's temperature and rapid breathing mean.
Description of the disease
Against the background of alveolar pulmonary edema to the clinical picturefrequent noisy breathing is added along with coarse bubbling wet rales audible at a distance. The patient develops a cough with the release of liquid serous pink sputum. Sometimes it becomes difficult to breathe while 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 in alveolar pulmonary edema is difficult to confuse with something.
Wheezing may initially be present in the lower back 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, a protodiastolic gallop rhythm can be heard. Arterial pressure, as a rule, drops sharply. The pulse on the radial artery is present rapid, and sometimes arrhythmic.
Different from 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 the pain syndrome and the use of several Nitroglycerin pills indicates the presence of cardiac asthma. Directly for alveolar edema, paroxysmal suffocation is characteristic, the appearance of moist and finely bubbling rales in the lower sections of the lungs.
Next, we turn to the consideration of the symptoms that are observed in patients in the event of alveolar edema.
Symptomatics
Clinical symptoms of a pathology such as alveolar pulmonary edema are the following manifestations:
- Appearance abruptlypronounced suffocation, and, in addition, coughing with the release of an excessive amount of foamy sputum with blood impurities.
- The presence of bubbling breath. At the same time, wet rales can be heard even at a distance. In addition, a cyanotic face is noted along with swollen jugular veins and cold sweat.
- Against the background of the described pathology, the patient's pulse is frequent, weak and arrhythmic, and blood pressure is lowered, and heart sounds are muffled.
- Various rales can be heard in the lungs over the entire surface.
Now let's look at the reasons that provoke the occurrence in people of such a pathology as alveolar pulmonary edema.
Reasons
The causes of this swelling may be the following factors:
- Diseases that are accompanied by the release of endogenous toxins, and, in addition, pneumonia.
- Overdose of drugs (especially Fentanyl and Apressin).
- Radiation damage.
- Using drugs in the form of heroin or cocaine. The fact is that toxins violate the integrity of the alveolocapillary membranes, which increases their permeability, and the capillary fluid enters the extravascular area.
- Presence of heart diseases in the stage of decompensation, which are accompanied by insufficiency of the left ventricle and blood stasis.
What other causes of alveolar pulmonary edema are known? The disease can develop:
- Against the background of the lungsdiseases that lead to stagnation in the region of the right circulatory circle. For example, this can happen with bronchial asthma and emphysema.
- With pulmonary embolism. This is especially true for individuals who are predisposed to the formation of 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 a decrease in 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 edema.
- Pulmonary edema is common in the elderly.
Diagnosis
As part of the diagnosis of pulmonary edema (according to ICD 10 - J81), the following procedures are performed:
- Performing an electrocardiogram.
- Performing x-rays for 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 in the death of the patient, therefore, at the initial manifestation of a respiratory disorder, especially against the background of a heart or lung disease, the patient needs to call an ambulance or mobileresuscitation without the slightest delay. Next, we will find out what exactly is the provision of emergency care in the event of this pathology, and find out what is the procedure for conducting cardiopulmonary resuscitation.
Emergency
The first measures taken by relatives, colleagues, friends and passers-by for pulmonary edema before the arrival of doctors should be as follows:
- In the event that a person has not lost consciousness, then he must be carefully planted so that the upper body takes a vertical position.
- We need to open the vents and windows so that more oxygen enters the room.
- Unfasten all items of clothing that put pressure on the chest and tighten the stomach.
- The patient is given a Nitroglycerin tablet to suck under the tongue. They also give "Furosemide" to remove excess fluid from the swollen tissue.
- A person needs to be able to breathe through alcohol vapor in order to extinguish the foamy discharge. In a home or office setting, soak gauze with alcohol and allow the patient to breathe through it.
Be aware that Nitroglycerin causes a sharp drop in blood pressure and loss of consciousness, which can aggravate the situation. Therefore, this medication is given only if the blood pressure is monitored continuously. It is better to use a sublingual spray, such as Nitrospray or Nitromint, which are more effective in emergency situations.
CPR procedures must be strictly followed.
Now let's move on to the mainmethods of treatment that are used by doctors in case of a patient with this disease.
Inpatient treatment
The following measures are taken by qualified specialists:
- Saturation of the lungs with oxygen is provided. In addition, oxygen inhalations are carried out through an alcohol solution. At the same time, cannulas are introduced into the nasal passages to destroy foaming. In especially dangerous situations, tracheal intubation is performed, forced ventilation of the lungs is performed.
- An injection of morphine hydrochloride (5 milligrams) is given intravenously, and if necessary, the procedure is repeated after twenty minutes. Morphine eliminates nervous overexcitation 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. Among other things, this substance reduces pressure in the central pulmonary artery. The 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, he is prescribed a morphine antagonist in the form of "Naloxone".
- A gentle pressure tourniquet is applied to the upper thighs. In this case, it is important to control that the pulse is felt. The tourniquet is removed after twenty minutes. This is necessary in order to reduce blood flow to the heart and reduce pressure.
- Nitroglycerin should be used with caution 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 pre-moisten your mouth with water, as the mucosa dries out during swelling. After that, 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 carried out under the condition of constant pressure control. Pressure should not be allowed to fall 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 increases 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, a specific property: along with the stimulation of myocardial contractions, thanks to it, the vessels of the heart, kidneys, brain, intestines expand, and, in addition, blood circulation in them improves. Dobutamine is administered through a drip at 175 micrograms per minute with a slow increase in dosage to 300.
- Diuretic therapy is mandatory to increase diuresis, thereby reducing venous blood congestion in the lungs. 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 an acute heart attack, as part of the narrowing of the atrioventricular orifice, and, moreover, if the patient has high blood pressure, since these drugs can cause a backlash, leading to aggravation of alveolar edema. In this regard, the worsecondition of the heart muscle, the more caution should be used cardiac glycosides.
- In the event that paroxysmal arrhythmia in the form of ventricular tachycardia is observed during edema, eclectic impulse therapy is urgently used.
- In the event that bronchospasm occurs during edema, patients are given "Eufillin", as well as hormonal agents in the form of "Prednisolone" or "Dexamethasone".
Additional treatment measures
Additionally and without fail, such means as:
- If there is a small amount of protein in the blood, "Albumin" is injected into the patient intravenously.
- Against the background of symptoms of blockage of the pulmonary and coronary arteries by a blood clot, "Heparin" is used along with "Pentoxifylline", which thin the blood and prevent platelets from sticking together into clots. That is, thanks to this, aggregation is excluded.
- When bradycardia is present, a drug called Atropine is often used.
Bleeding 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 options will be useless.
Standard medical treatment is the main guarantee of saving a patient in case of alveolar edema. But besides this, as part of complex treatment, you can also turn to folk methods.
Whatprognosis for pulmonary edema?
The prognosis is influenced by the type of edema, severity, concomitant ailments, as well as how quickly and efficiently medical care was provided to a person. 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 is observed with this form of edema.
Let's consider folk remedies for cough and the most effective recipes.
Folk remedies
In folk medicine, there are many remedies that can help the patient in the presence of alveolar edema, both as part of the prevention and treatment of such a dangerous disease. Folk methods can be used to prepare expectorant decoctions from anise seeds on honey. You can prepare such a medicine as follows: three spoons are poured into 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 listed below.
Another folk remedy recommended for pulmonary edema is a decoction of flaxseeds. In order to prepare it with a liter of water, four tablespoons of flax seeds are poured, boiled, removed from heat and allowed to brew in some warm place. Then the resulting remedy is filtered and taken half a glass six times a day every two hours.
Now the ancient methods of therapy are increasingly remembered in the treatment of patients,who are 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 cyanosis roots. To prepare a decoction, 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 70 milliliters four times after meals.
To prevent pulmonary edema in the elderly, namely in bedridden patients, they must be turned over from one side to the other several times a day if there are no contraindications for this.
