scholarly journals Neurological Perspectives of Neurogenic Pulmonary Edema

2019 ◽  
Vol 81 (1-2) ◽  
pp. 94-102 ◽  
Author(s):  
Josef Finsterer
Keyword(s):  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Enterovirus 71 ◽  
Neurogenic Pulmonary Edema ◽  
Brainstem Encephalitis ◽  
Simultaneous Treatment ◽  
X Ray ◽  
Subarachnoid Bleeding ◽  
The Central Nervous System ◽  
Intra Cranial Pressure

Background: Neurogenic pulmonary edema (NPE) is characterized by acute respiratory distress triggered by acute, severe compromise of the central nervous system (CNS). This review aims at summarizing and discussing recent and previous findings about the type and frequency of CNS triggers of NPE, pathogenesis, diagnosis, treatment, and outcome of patients experiencing NPE. Key Messages: NPE is diagnosed in the presence of pink, frothy sputum, pulmonary edema, bilateral opacities on X-ray, PaO2:PiO2 <200 mm Hg, acute CNS compromise with increased intra-cranial pressure, rapid resolution within 48–72 h, and the absence of alternative causes of respiratory distress. The most common cerebral triggers of NPE include enterovirus-71-associated brainstem encephalitis, subarachnoid bleeding, intracerebral bleeding, traumatic brain injury, epilepsy, ischemic stroke, intracranial/spinal surgery, multiple sclerosis, electroconvulsive therapy, subdural/epidural hematoma, intoxication, hypoxia, and hydrocephalus. Simultaneous treatment of CNS and pulmonary compromise is required. Cerebral treatment involves infectiologists, neurologists, and neurosurgeons. Pulmonary treatment is mainly supportive, but if ineffective, extracorporeal membrane oxygenation or thermodilution are alternative options. Applying intensive care measures, the outcome of NPE has improved. Summary: CNS-disease triggering NPE is more variegated than anticipated. Delineation of NPE from other pulmonary or cardiac conditions mimicking NPE is crucial to take appropriate measures and improve the outcome of these patients.

scholarly journals Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation

2013 ◽  
Vol 53 (1) ◽  
pp. 6
Author(s):  
Indah Nurhayati ◽  
Muhammad Supriatna ◽  
Kamilah Budhi Raharjani ◽  
Eddy Sudijanto
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Study ◽  
Pleural Effusion ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Patient Outcomes ◽  
Morbidity And Mortality ◽  
Chi Square ◽  
X Ray ◽  
Chest X Ray

Background Most infants and children admitted to the pediatricintensive care unit (PICU) have respiratory distress and pulmonarydisease as underlying conditions. Mechanical ventilation may beused to limit morbidity and mortality in children with respiratoryfailure.Objective To assess a correlation between chest x-ray findingsand outcomes of patients with mechanical ventilation.Methods This retrospective study was held in Dr. KariadiHospital, Semarang, Indonesia. Data was collected from themedical records of children admitted to the PICU from Januaryto December 2010, who suffered from respiratory distress andused mechanical ventilation. We compared chest x-ray findings tothe outcomes of patients. Radiological expertise was provided byradiologists on duty at the time. Chi-square and logistic regressiontests were used for statistical analysis.Results There were 63 subjects in our study, consisting of 28 malesand 35 females. Patient outcomes were defined as survived or died,43 subjects ( 68%) and 20 subjects (3 2%), respectively. Chest x-rayfindings revealed the following conditions: bronchopneumonia48% (P=0.298; 95%CI 0.22 to 1.88), pleural effusion 43%(P=0.280; 95%CI 0.539 to 4.837) , pulmonary edema 6%(P=0.622; 95%CI 0.14 to 14.62) and atelectasis 3% (P=0.538;95%CI 0.03 to 7 .62). None of the chest x-ray findings significantlycorrelated to patient outcomes.Conclusion Chest x-ray findings do not correlate to patientoutcomes in pediatric subjects with mechanical ventilation inthe PICU of Dr. Kariadi Hospital, Semarang, Indonesia.

Acute Pulmonary Edema after Polyethylene Glycol Intestinal Lavage in a Child

1993 ◽  
Vol 27 (9) ◽  
pp. 1044-1047 ◽  
Author(s):  
Christopher M. Paap ◽  
Robert Ehrlich
Keyword(s):  
Polyethylene Glycol ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Ventilatory Support ◽  
Gastrointestinal Symptoms ◽  
Acute Pulmonary Edema ◽  
Severe Respiratory Distress ◽  
X Ray ◽  
Chest X Ray ◽  
Outpatient Settings

OBJECTIVE: To report the case of an eight-year-old girl, without preexisting cardiac or renal disease, who developed acute pulmonary edema and severe respiratory distress after balanced electrolyte with polyethylene glycol (BE-PEG) intestinal lavage. CASE SUMMARY: During the nasogastric infusion of a one-liter dose of BE-PEG (OCL, Abbott), the patient experienced abdominal discomfort, gagging, vomiting, and coughing. After the nasogastric infusion, the patient again had emesis, developed tachypnea, intercostal retractions, and acute respiratory distress. She received oxygen and subsequently required intubation and ventilatory support. Physical examination revealed pulmonary congestion bilaterally but no signs of cardiac failure or sepsis. Chest X-ray revealed bilateral pulmonary edema. Ventilatory support was continued for 36 hours and the patient was extubated after two days. DISCUSSION: Enteral BE-PEG may have caused acute pulmonary edema secondary to aspiration or systemic fluid overload. Although the exact cause remains unknown, the close temporal onset of pulmonary edema after BE-PEG administration in an otherwise healthy child suggests a causal relationship. CONCLUSIONS: This case should alert clinicians to the potential for significant morbidity with BE-PEG solutions, particularly if used in outpatient settings. Patients who receive BE-PEG should be closely observed and monitored for potential aspiration, excessive infusion rates, and gastrointestinal symptoms to optimize efficacy and reduce morbidity.

Community-Acquired Acute Respiratory Distress Syndrome (ARDS)

2010 ◽  
pp. 18-21
Author(s):  
Edward C. Rosenow
Keyword(s):  
Emergency Department ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Healthy Person ◽  
Acute Onset ◽  
Neurogenic Pulmonary Edema ◽  
Outpatient Basis ◽  
Near Drowning ◽  
High Altitude Pulmonary Edema

An otherwise healthy person without a known predisposing pulmonary condition presents to the emergency department with acute onset of respiratory distress • Noncardiac pulmonary edema ∘ Neurogenic pulmonary edema ∘ High-altitude pulmonary edema ∘ Near drowning ∘ Anaphylaxis ∘ Aspiration ∘ Transfusion-related acute lung injury (when blood products are given on an outpatient basis)...

scholarly journals Recurrent Acute Neurogenic Pulmonary Edema after Uncontrolled Seizures

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Daniel C. Sacher ◽  
Erika J. Yoo
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pulmonary Edema ◽  
Protective Ventilation ◽  
Lung Protective Ventilation ◽  
Neurogenic Pulmonary Edema ◽  
Cardiac Pathology ◽  
Source Of Infection ◽  
The Central Nervous System ◽  
Significant Injury

Acute pulmonary edema following significant injury to the central nervous system is known as neurogenic pulmonary edema (NPE). Commonly seen after significant neurological trauma, NPE has also been described after seizure. While many pathogenic theories have been proposed, the exact mechanism remains unclear. We present a 31-year-old man who developed recurrent acute NPE on two consecutive admissions after experiencing witnessed generalized tonic-clonic (GTC) seizures. Chest radiographs obtained after seizure during both admissions showed bilateral infiltrates which rapidly resolved within 24 hours. He required intubation on each occasion, was placed on lung protective ventilation, and was successfully extubated within 72 hours. There was no identified source of infection, and no cardiac pathology was thought to be contributory.

scholarly journals Pathogenesis of Enterovirus 71 Brainstem Encephalitis in Pediatric Patients: Roles of Cytokines and Cellular Immune Activation in Patients with Pulmonary Edema

2003 ◽  
Vol 188 (4) ◽  
pp. 564-570 ◽  
Author(s):  
Shih‐Min Wang ◽  
Huan‐Yao Lei ◽  
Kao‐Jean Huang ◽  
Jing‐Ming Wu ◽  
Jen‐Ren Wang ◽  
...  
Keyword(s):  
Pulmonary Edema ◽  
Immune Activation ◽  
Pediatric Patients ◽  
Enterovirus 71 ◽  
Brainstem Encephalitis ◽  
Cellular Immune

Sudden Death in Toddlers with Viral Meningitis, Massive Cerebral Edema, and Neurogenic Pulmonary Edema and Hemorrhage: Report of Two Cases

2006 ◽  
Vol preprint (2007) ◽  
pp. 1
Author(s):  
Henry Krous ◽  
Amy Chadwick ◽  
Douglas Miller ◽  
Laura Crandall ◽  
Hannah Kinney
Keyword(s):  
Sudden Death ◽  
Pulmonary Edema ◽  
Cerebral Edema ◽  
Viral Meningitis ◽  
Neurogenic Pulmonary Edema
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