Pulmonary edema (HAPE )

Pulmonary edema (HAPE) is a term used when there is a edema in the lungs. The area outside the small blood vessels in the lungs is occupied by tiny air sacs called alveoli. It helps where oxygen from the air is picked up by the blood and carbon dioxide in the blood is passed into the alveoli to be exhaled out. It is a thin wall that allow for air exchange and fluids are usually kept out of the alveoli.
It occurs when the alveoli fill up with excess fluid seeped out of the blood vessels in the lungs. This cause problem with the exchange of gas resulting in breathing difficulty and poor oxygenation of blood. It is referred as “water in the lungs “.

Causes of Pulmonary edema 

Pulmonary edema can be caused by different factors. It can be related to heart failure called cardiogenic pulmonary edema. It is related to other causes called non- cardiogenic pulmonary edema.
1) Cardiogenic causes of pulmonary edema – Congestive heart failure due to poor heart pumping function which is arising from various causes such as arrhythmias, weakness of the heart muscles, heart attacks or abnormal heart valves can leads to accumulation of the blood in the blood vessels of the lung.

2) Non- cardiogenic pulmonary edema –

• Acute respiratory distress syndrome (ARDS) – It is caused by severe infection, trauma, and lung injury, inhalation of toxins, cocaine smoking .The integrity of the alveoli become compromised as a result of inflammatory response which leads to fill up with fluid from the fluid from the blood vessels.
• Kidney failure – If there is an inability to excrete fluid from the body can cause fluid buildup in the blood vessels resulting in pulmonary edema. People with advanced kidney disease, dialysis is necessary to remove the excess body fluid.
• High altitude pulmonary edema happens due to rapid ascent to high altitude.
• Brain trauma, bleeding in the brain, severe seizure, brain surgery result in fluid accumulation in the lungs causing neurogenic pulmonary edema.
• Due to pneumothorax and pleural effusion there is rapid expansion of the lungs .This can leads to pulmonary edema.
• Overdose of aspirin leads to aspirin intoxication especially in elderly person which leads to pulmonary edema.
• Pulmonary embolism is one of the causes of non –cardiogenic pulmonary edema.

Pulmonary edema sign and symptoms

1) Shortness of the breathe (Breathlessness).
2) Easy fatigue.
3) Dyspnea on exertion.
4) Rapid breathing.
5) Hypoxia (low blood oxygen level).
6) Abnormal lung sounds such as rattling sound.

Investigations of Pulmonary edema

• It can be diagnosed by chest X-ray. It shows white appearance over both lung fields.
• Measurement of plasma B- type natriuretic peptide (BNP)

Treatment for Pulmonary edema

• Cardiac pulmonary edema is treated with diuretics.
• In case of non cardiac pulmonary edema severe infection is caused by antibiotics.
• Oxygen supplementations should be given if the oxygen level in the blood is too low.

Complications of Pulmonary edema

Poor oxygenation (hypoxia) leads to diminished oxygen delivery to different parts of the body.

Prevention of Pulmonary edema

1) Prevention of heart disease and heart attacks.
2) Slow elevation to high altitudes.
3) Avoidance of drug overdose should be prevented.

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