पल्मोनरी इडिमा

पल्मोनरी इडिमा] सोंय् फ्लुइड जम्मा जुइगु व सों मनावैगु छगु अवस्था खः। थुकिलिं याना ग्यांस हिलेत थाकुइ व रेस्पिरेटरी फेल्युवर नं जुइ फु। थ्व नुगलं सों सर्कुलेसनं तरलतः पिथने मफया (कार्डियोजेनिक) वा सोंयु प्यारेन्काइमायु ल्वेनं(नन-कार्डियोजेनिक) याना जुइगु खः।Ware LB, Matthay MA. Acute pulmonary edema. N Engl J Med 2005;353:2788-96. PMID 16382065. Treatment depends on the cause, but focuses on maximizing respiratory function and removing the cause.

लक्षण
थुकिगु लक्षणत खः
 सास ल्हाय् थाकुइगु,
 हेमोप्टाइसिस, 
यक्व चति वैगु,
एंजाइटी व
 प्यालोर 

थ्व अवस्थायु उपचार मयासा मनु हाइपोक्सिया जुया सी नं फु। 

If pulmonary edema has been developing gradually, symptoms of fluid overload may be elicited. These include nocturia (frequent urination at night), ankle edema (swelling of the legs, generally of the "pitting" variety, where the skin is slow to return to normal when pressed upon), orthopnea (inability to lie down flat due to breathlessness) and paroxysmal nocturnal dyspnea (episodes of severe sudden breathlessness at night).

डायग्नोसिस
Pulmonary edema is generally suspected due to findings in the medical history, such as previous cardiovascular disease, and physical examination: end-inspiratory crackles (sounds heard at the end of a deep breath) on auscultation (listening to the breathing through a stethoscope) are characteristic for pulmonary edema. The presence of a third heart sound (S3) is predictive of cardiogenic pulmonary edema.

Blood tests are generally performed for electrolytes (sodium, potassium) and markers of renal function (creatinine, urea). Liver enzymes, inflammatory markers (usually C-reactive protein) and a complete blood count as well as coagulation studies (PT, aPTT) are typically requested. B-type natriuretic peptide (BNP) is available in many hospitals, especially in the US, sometimes even as a point-of-care test. Low levels of BNP (<100 pg/ml) make a cardiac cause very unlikely.

The diagnosis is confirmed on X-ray of the lungs, which shows increased fluid in the alveolar walls. Kerley B lines, increased vascular filling, pleural effusions, upper lobe diversion (increased blood flow to the higher parts of the lung) may be indicative of cardiogenic pulmonary edema, while patchy alveolar infiltrates with air bronchograms are more indicative of noncardiogenic edema

Low oxygen saturation and disturbed arterial blood gas readings may strengthen the diagnosis and provide grounds for various forms of treatment. If urgent echocardiography is available, this may strengthen the diagnosis, as well as identify valvular heart disease. In rare occasions, insertion of a Swan-Ganz catheter may be required to distinguish between the two main forms of pulmonary edema.

कारक
Pulmonary edema is either due to direct damage to the tissue or as a result of inadequate functioning of the heart or circulatory system.

कार्डियोजेनिक
 कन्जेस्टिभ नुग फेल्युवर
 तच्वगु  ह्रिदयघाट with left ventricular failure
 तच्वगु कार्डियाक अरिदमिया (tachycardia/fast heartbeat or bradycardia/slow heartbeat)
 हाइपरटेन्सिभ क्राइसिस
 पेरिकार्डियल इफ्युजन टेम्पोनाड नापं
 फ्लुइड ओभरलोड, द्सुः- रेनल फेल्युवरनं

नन-कार्डियोजेनिक
This form is contiguous with ARDS (एक्ञुट रेस्पिरेटरी डिस्ट्रेस सिन्ड्रम):
 टक्सिक ग्यांस नतुनां
 यक्व हि ट्रान्स्फ्युजन
 तच्वगु संक्रमण
 पल्मोनरी कन्ट्युजन, i.e. तच्व-उर्जा ट्रमा
 मल्टीट्रमा, e.g. severe car accident
 न्युरोजेनिक, e.g. सबएराक्नोइड हेमोरेज
 पल्मोनरी एस्पिरेसन, e.g. gastric fluid or in case of drowning
 छुं वासलं
 च्वेयागु एअरवे अब्स्ट्रक्सन
 रिएक्स्पान्सन, i.e. पोस्टन्युमोनेक्टोमी वा यक्व थोर्‍याकोसेन्टेसिस
 रिपर्फ्युजन घा/इन्ज्युरी, i.e. postpulmonary थ्रोम्बोएन्डार्टेक्टोमी वा सों प्रत्यारोपण
 Ascent to high altitude occasionally causes high altitude pulmonary edema (HAPE)

थेरापी
Focus is initially on maintaining adequate oxygenation. This may happen with high-flow oxygen, noninvasive ventilation (either continuous positive airway pressure (CPAP) or variable positive airway pressure (VPAP)Masip J, Roque M, Sanchez B, Fernandez R, Subirana M, Exposito JA. Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis. JAMA 2005;294:3124-30. PMID 16380593.Peter JV, Moran JL, Phillips-Hughes J, Graham P, Bersten AD. Effect of non-invasive positive pressure ventilation (NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema: a meta-analysis. Lancet 2006;367(9517):1155-63. PMID 16616558.) or mechanical ventilation in extreme cases.

When circulatory causes have led to pulmonary edema, treatment with intravenous nitrates (glyceryl trinitrate), and loop diuretics, such as furosemide or bumetanide, is the mainstay of therapy. These improve both preload and afterload, and aid in improving cardiac function.

There are no causal therapies for direct tissue damage; removal of the causes (e.g. treating an infection) is the most important measure.

श्रोत

स्वया दिसं
High Altitude Pulmonary Edema
Flash pulmonary edema

पिनेयागु स्वापू
 Medical Encyclopedia entry

पुचः:पल्मोनोलोजी
पुचः:इमर्जेन्सी मेडिसिन