Forms of pulmonary edema. Laboratory diagnostic methods. Traditional medicine methods

Pulmonary edema, the causes and consequences of which can be quite serious, is dangerous disease threatening the patient's life.

Therefore, if this symptom is detected in a person, immediate consultation with a doctor is required.

Pulmonary edema occurs due to exposure to an external factor affecting the accumulation serous fluid in the alveoli, which leads to disruption of the exchange of carbon dioxide and oxygen. The lung may swell due to blood stagnation or damage to the lung structure.

This symptom is very dangerous for human life. If the patient is not provided with qualified medical care in a timely manner, the consequences can be dire. Often, swelling of the lung causes death.

The alveoli, which make up the lungs, are thin sacs covered with small blood vessels. If swelling occurs, they fill with fluid, which leads to a disruption in the functioning of the organ and the exchange of oxygen with carbon dioxide. As a result, oxygen starvation of all organs occurs.

In medicine, there are two types of pulmonary edema: hydrostatic edema and membrane edema.

Hydrostatic and membranous edema

The reasons why this problem occurs are quite varied. This can include any illness or condition human body, in which there is an increase in pressure in the lungs.

As a rule, this is a heart defect (acquired or congenital), diseases associated with the heart valve, thrombosis, pulmonary failure and embolism, tumors (especially malignant), bronchial asthma and obstructive heart disease in chronic form.

This type pulmonary edema may arise due to infectious diseases And inflammatory processes, therefore it is not excluded in pneumonia and sepsis. In addition, membranous edema occurs during poisoning harmful fumes, for example, chlorine, carbon monoxide or mercury. Often the cause is the entry of stomach contents into the alveoli.

Swelling can occur due to the penetration of water into the alveoli, as well as as a result of foreign objects into the respiratory tract.

Edema in heart disease

With congenital or acquired diseases of the heart and blood vessels, the possibility of developing swelling in the lungs cannot be ruled out. The reason for this is insufficient blood circulation, which leads to increased blood pressure. If there is blood long time is located in the walls of blood vessels, its plasma begins to penetrate the alveoli and accumulate there.

Pulmonary edema often occurs in people when acute heart attack myocardium, post-infarction cardiosclerosis or atherosclerotic, heart disease (acquired and innate nature), left ventricular dysfunction, as well as diastolic and systolic dysfunction.

Intoxication and lung diseases

If the alveoli of the lungs are exposed to harmful substances or aggressive compounds, this can lead to swelling of the organ and death of the patient. This happens when a person inhales toxic gases or poison, as well as when taking certain medications incorrectly.

Other types of intoxication that can lead to pulmonary edema include drug or alcohol poisoning. A similar reaction is possible if you are allergic to certain substances. Pulmonary edema often causes death.

Infection in the body also leads to toxin poisoning. This can also cause swelling in the lungs. Thus, dangerous symptom may occur with sepsis, influenza, chronic tonsillitis, acute laryngitis and whooping cough.

Diseases that affect the organ itself can cause pulmonary edema. This happens when chronic bronchitis, lung tumors, tuberculosis, bronchial asthma and pneumonia.

Sometimes the problem is caused by problems not only in the lung itself, but also in other organs. For example, fluid accumulation may occur due to improper functioning of the kidneys and liver. If there is a predisposition to this, then swelling can develop even due to physical or emotional stress.

Climate change

When it comes to acclimatization, you need to be extremely careful. This is especially true for those who are going to travel with a sharp change in climate or go high into the mountains. Experts note that often those who decide to climb to a high altitude for the first time may experience serious problems with the body, including swelling of the lungs. As a rule, this is observed when a person crosses 3.5 thousand meters above sea level. When significant physical activity is added to this, the risk of developing the worst scenario increases significantly.

If a person climbs a mountain, this does not mean that the problem will manifest itself immediately. In most cases, about three days pass before swelling develops, only then do the first signs appear. People who have chronic ailments of the respiratory system or circulatory problems are at particular risk. In this case, the patient has a dry cough for some time, severe weakness and sore throat.

For highlands similar symptom very dangerous. It is not always possible to quickly go to the clinic for help with pulmonary edema. In this case, swelling can develop very quickly, and the death of the patient becomes inevitable.

The first thing to do in such a situation is to carry out warming procedures. In this case, the person needs to be laid down, but the head should be raised slightly. Pain symptoms need to be removed with appropriate medications. Acidified water is recommended for drinking. If possible, the patient should be provided with additional oxygen.

Help from specialists in this case will be extremely necessary, otherwise the patient’s chances of survival are minimal.

How to recognize pulmonary edema?

This problem manifests itself in several characteristic features, so diagnosing it is not difficult. Depending on the speed of development of symptoms of pulmonary edema and pathogenesis, the disease can be divided into four stages.

Approaching swelling is indicated by shortness of breath, rapid breathing and pulse, severe cough and wheezing in the throat. If the patient puts pressure on the chest, it will cause painful sensations. The later stage is characterized by rapid heartbeat, cold sweat and difficulty breathing. A person tries to stay in a sitting position more, because this makes breathing much easier.

If at first a dry cough predominates, then at a more advanced stage it will develop into a wet one. In this case, wheezing is heard and pinkish sputum appears, which over time can come out through the nose.

Acute pulmonary edema is characterized by bubbling, intermittent and loud breathing. As soon as pulmonary edema increases, other symptoms are sure to appear (low blood pressure, weak pulse and loss of consciousness).

All stages of pulmonary edema appear with at different speeds. Much depends on how quickly fluid accumulates in the alveoli. If we are talking about fulminant edema, then everything happens so quickly that even an ambulance sometimes does not have time to save the patient. At gradual development symptoms, the patient or his loved ones have the opportunity and time to seek qualified help from professionals.

Consequences of edema

If a person experiences symptoms of swelling of the respiratory system, this is quite dangerous and can cause death. For this reason, pulmonary edema requires urgent medical attention for treatment.

It must be remembered that this disease often becomes the reason oxygen starvation throughout the body and leads to failure of internal organs. This is especially dangerous for the brain.

The prognosis for timely treatment of pulmonary edema is quite favorable. In most cases, everything ends well. If medical care there will be no, even with the slow development of swelling, the likelihood of death is extremely high. Most likely, the patient will die from asphyxia.

With timely and proper treatment, pulmonary edema responds well to treatment, many patients recover completely and no problems arise in the future. The only case when doctors cannot guarantee a positive result is pulmonary edema, which is combined with cardiogenic shock. In such a situation, recovery is rather rare.

Pulmonary edema is not a separate disease, but rather a complication of a number of pathologies. Its essence lies in the excessive accumulation of fluid in the tissues of the lung, its sweating into the lumen of the alveoli, which leads to a deterioration in respiratory function and the death of the patient.

Anatomy and physiology of the pulmonary gas exchange system

The lungs are a complex of hollow tubes of small diameter, at the end of each of which there are alveoli - saccular thin-walled formations filled with air. All these structures are shrouded in threads consisting of connective tissue. These threads form a kind of framework that forms the lung itself and is called the interstitium. Part of the interstitium is the interalveolar septa, penetrated by capillaries.
The wall of the alveoli and capillary, together with the interstitial tissue, form an alveolo-capillary membrane (ACM) 0.2-2 microns thick, through which oxygen and carbon dioxide diffuse into/from the blood.

Mechanism and causes of development of pulmonary edema

The appearance of pulmonary edema (PE) can be caused by many reasons, but regardless of the factor that caused the complication, the mechanism of its development is the same - the accumulation of excess fluid in the interstitial tissues, the resulting thickening of the alveolar-capillary membrane and a decrease in the diffusion of gases (primarily oxygen). As a result, tissue hypoxia occurs (oxygen starvation of all tissues) and acidosis - shift acid-base balance, leading to the inevitable death of the patient if he is not provided with emergency assistance.
There is no unified classification of pulmonary edema, but according to the pathogenetic mechanism it can be divided into:

1. OB due to increased capillary pressure as a result of:
   • acute;
   • cardiac;
   • cardiomyopathies;
   • myocarditis;
   • exudative pericarditis;
   • pulmonary artery stenosis;
   • massive infusion of blood replacement solutions;
   • renal failure in the anuric phase.
2. OB due to increased permeability of the capillary wall with:
   • acute respiratory distress syndrome;
   • intoxications (for example, narcotic drugs);
   • anticancer chemotherapy;
   • use of X-ray contrast agents;
   • inhalation of toxic substances;
   • allergies.
3. OB due to impaired lymphatic drainage due to cancerous lesions of the lymphatic vessels.
4. OB due to changes in intrathoracic interstitial pressure during decompression sickness and evacuation (removal) of fluid from the pleural cavity.
5. OL due to a decrease in protein content in the blood plasma.
6. Mixed OL:
   • neurogenic;
   • postoperative;
   • with eclampsia;
   • with ovarian hyperstimulation syndrome;
   • with altitude sickness.

Previously, a classification was used that included types of pulmonary edema such as interstitial and alveolar. Currently, it has been abandoned, since these two types of OA are actually only stages of the development of the syndrome. In addition, in terms of diagnosis and treatment, such a division does not bear any useful function.
Normally, only a small amount of fluid from the interstitium penetrates into the alveoli. Almost all of it is absorbed into the blood and lymphatic capillaries and removed from the alveolo-capillary membrane. However, if the permeability of the ACM is impaired, there is too much fluid and it does not have time to move all of it into the vessels. In this case, it permeates the interstitium, increasing its thickness, and in the most advanced situation it begins to enter the lumen of the alveoli, further worsening gas exchange.

The symptoms of pulmonary edema depend little on the factors that led to its development. The difference between OL caused by disorders in cardiovascular system, and edema not associated with cardiac causes, lies only in the speed of development of the pathology.

OL associated with disorders in the circulatory system

With cardiogenic pulmonary edema (caused by circulatory disorders), the first symptom is cardiac asthma, manifested by shortness of breath at rest, increased respiratory movements, a feeling of severe lack of air, and suffocation. Most often, the attack begins at night, the patient immediately wakes up and takes a sitting position in which it is easier for him to breathe. At the same time, he lowers his legs from the bed and rests his hands on its edge. This is the orthopnea position, which is accepted by almost every patient.
The onset of pulmonary edema is characterized by a desire to go to the window and breathe fresh air. In this state, the patient practically does not speak, but emotional stress is clearly visible on his face. As doctors put it, “the patient is completely given over to the fight for air.” The skin becomes pale, nasolabial triangle acquires a bluish color (acrocyanosis). This indicates an increase in hypoxia. Cold, sticky sweat may appear - a sign of impending cardiogenic shock, which is an extremely severe complication of any cardiac pathology. With further development, the patient's breathing becomes noisy, bubbling in his chest can be heard even at a distance, and pink, foamy sputum may be released in large volumes. At this stage, the amount of liquid already far exceeds the capacity of the capillaries to remove it, and the liquid part of the blood begins to penetrate into the alveoli.

Non-cardiogenic edemalungs

In this case, the phenomena of pulmonary edema arise due to damage to the alveolo-capillary membrane by various factors (microbial toxins, chemicals, allergy mediators, etc.). Unlike cardiogenic, this type of AL appears only after a relatively for a long time after exposure to the damaging agent (up to 48 hours). Symptoms are not cardiogenic edema the lungs are exactly the same as its cardiac form. The only difference is that cardiogenic OA is much easier to treat and resolves faster, completely disappearing after 2-4 days. Non-cardiogenic edema has to be treated for 1-3 weeks, very often (up to 80% of cases) it ends in death. But even in case successful treatment this form of OA is accompanied by persistent residual effects.

Diagnosis of pulmonary edema

Anamnesis data are very important for diagnosing pulmonary edema. And although sometimes it is not possible to obtain them, it is information about existing diseases that can lead the doctor to think about the causes of the complication. After clarifying the medical history, the patient is examined and auscultated. At this point, color changes are detected skin and mucous membranes, profuse sweat, attention is paid to the patient’s posture when breathing, his behavior. When listening to the lungs, wheezing is noted, hard breathing, when listening to the heart - muffling of its tones, “gallop” rhythm, noises. The main indicator of pulmonary edema is a decrease in blood oxygen saturation. To identify it, pulse oximetry is used - a method available to any ambulance team.
Hemodynamic disorders are detected by measuring blood pressure and heart rate counting. It is mandatory to conduct emergency electrocardiography taking into account the patient's condition - this method allows you to identify the causes of the cardiogenic form of edema and develop optimal treatment tactics. In a hospital setting, an additional chest x-ray is performed, which reveals signs of pulmonary edema and some pathologies that led to it. Using this study, it is possible to relatively accurately differentiate the causes of the disease. Other methods for diagnosing pathology are also used:

• echocardiography, which allows to identify abnormalities or pathology of the heart valves leading to hemodynamic disorders;
• catheterization of the pulmonary artery to detect changes in pressure indicators in this vessel;
• transpulmonary thermodilution, which allows you to determine the degree of edema;
• biochemical blood test, which identifies some pathological conditions that can lead to OL;
• blood gas composition - essential analysis, giving information about blood saturation with oxygen and carbon dioxide.

Treatment and emergency care for pulmonary edema

The first step in treatment of OA is oxygen therapy. Inhaling pure oxygen to patients can reduce the degree of hypoxia, straighten the alveoli and improve the transport of gases into the blood. This gives doctors the necessary time to administer medications that can eliminate the pathology. In the presence of hemorrhagic foam, oxygen is passed through aqueous-alcohol solution, since ethanol is capable of destroying bubbles. If there is no effect from standard oxygen therapy, they switch to inhaling oxygen through a breathing mask under pressure. In particular severe cases tracheal intubation may be required and artificial ventilation lungs. Drug therapy depends on the pathology that led to the development of pulmonary edema:

Decrease in systolic blood pressure below 90 mm Hg. Art. is an unfavorable sign. In this case, nitrates are contraindicated even in the presence of a heart attack; dopamine drugs are prescribed instead. A frequent “companion” of cardiogenic pulmonary edema is bronchospasm. When this syndrome is detected, bronchodilators are prescribed.

Prevention of pulmonary edema

Since this syndrome most often occurs in people suffering from chronic diseases, timely treatment can reduce the likelihood of pulmonary edema. It is impossible to completely exclude its occurrence, especially with long-term arrhythmias, coronary heart disease, heart defects and heart failure. However, careful monitoring of the condition by a doctor and strict adherence to all medical recommendations helps to avoid decompensation of these diseases, and therefore the development of their complications, including pulmonary edema. Bozbey Gennady, medical columnist, emergency doctor

Pulmonary edema is pathological condition, which is caused by the sweating of non-inflammatory fluid from the pulmonary capillaries into the interstitium of the lungs and alveoli, leading to a sharp disruption of gas exchange in the lungs and the development of oxygen starvation of organs and tissues - hypoxia. Clinically this state manifests itself as a sudden feeling of lack of air (suffocation) and blueness (cyanosis) of the skin. Depending on the causes that caused it, pulmonary edema is divided into 2 types:

• membranous (develops when the body is exposed to exogenous or endogenous toxins that violate the integrity vascular wall and the walls of the alveoli, as a result of which fluid from the capillaries enters the lungs);
• hydrostatic (develops against the background of diseases, causing an increase hydrostatic pressure inside the vessels, which leads to the release of blood plasma from the vessels into the interstitial space of the lungs, and then into the alveoli).

Causes and mechanisms of development of pulmonary edema

Pulmonary edema is not an independent disease, but a condition that is a complication of other pathological processes in the body.

Pulmonary edema can be caused by:

• diseases accompanied by the release of endogenous or exogenous toxins (infection entering the bloodstream (sepsis), pneumonia (pneumonia), drug overdose (Fentanyl, Apressin), radiation damage to the lungs, narcotic substances– heroin, cocaine; toxins violate the integrity of the alveolocapillary membrane, as a result of which its permeability increases, and fluid from the capillaries exits into the extravascular space;
• heart disease in the stage of decompensation, accompanied by left ventricular failure and stagnation of blood in the pulmonary circulation (heart defects);
• pulmonary diseases leading to stagnation in the right circulation (bronchial asthma, emphysema);
• pulmonary embolism (in persons predisposed to thrombus formation (suffering from hypertension, etc.), a blood clot may form, followed by its separation from the vascular wall and migration with the bloodstream throughout the body; reaching the branches of the pulmonary artery, the thrombus can clog its lumen, which will cause an increase in pressure in this vessel and the capillaries branching from it - hydrostatic pressure increases in them, which leads to pulmonary edema);
• diseases accompanied by a decrease in protein content in the blood (liver cirrhosis, kidney pathology with nephrotic syndrome, etc.); in the above conditions, the oncotic pressure of the blood decreases, which can cause pulmonary edema;
• intravenous infusions(infusions) of large volumes of solutions without subsequent forced diuresis lead to an increase in hydrostatic blood pressure and the development of pulmonary edema.

Signs of pulmonary edema

Symptoms appear suddenly and increase rapidly. Clinical picture The disease depends on how quickly the interstitial stage of edema transforms into the alveolar stage.

Based on the rate of progression of symptoms, they are divided into following forms pulmonary edema:

• acute (signs of alveolar edema appear 2–4 hours after the appearance of signs of interstitial edema) – occurs with defects mitral valve(usually after psycho-emotional stress or excessive physical activity), myocardial infarction;
• subacute (lasts from 4 to 12 hours) – develops due to fluid retention in the body, with acute hepatic or congenital heart defects and great vessels, lesions of the lung parenchyma of a toxic or infectious nature;
• prolonged (lasting 24 hours or more) – occurs in chronic renal failure, chronic inflammatory diseases lungs, systemic diseases connective tissue (, vasculitis);
• fulminant (a few minutes after the onset of swelling leads to fatal outcome) – observed when anaphylactic shock, extensive heart attack myocardium.

At chronic diseases Pulmonary edema usually begins at night, which is associated with prolonged stay of the patient in horizontal position. In the case of pulmonary embolism, the development of events at night is not at all necessary - the patient’s condition can worsen at any time of the day.

The main signs of pulmonary edema are:

• intense shortness of breath at rest; breathing is frequent, shallow, bubbling, it can be heard from a distance;
• a sudden feeling of a sharp lack of air (attacks of painful suffocation), intensifying when the patient lies on his back; such a patient takes the so-called forced position - orthopnea - sitting with the torso bent forward and supported by outstretched arms;
• pressing, squeezing pain in the chest caused by lack of oxygen;
• severe tachycardia (rapid heartbeat);
• cough with distant wheezing (audible at a distance), discharge of pink foamy sputum;
• pallor or blue discoloration (cyanosis) of the skin, profuse sticky sweat - the result of centralization of blood circulation in order to provide oxygen to vital organs;
• patient's agitation, fear of death, confusion or total loss such a coma.

Diagnosis of pulmonary edema

If the patient is conscious, the doctor’s primary concern is his complaints and anamnesis data - he conducts a detailed questioning of the patient in order to establish possible reason pulmonary edema. In the case where the patient is not available for contact, a thorough objective examination of the patient comes to the fore, allowing one to suspect edema and suggest the reasons that could lead to this condition.

When examining a patient, the doctor’s attention will be drawn to pallor or cyanosis of the skin, swollen, pulsating veins of the neck ( jugular veins) as a result of stagnation of blood in the pulmonary circulation, rapid or shallow breathing of the subject.

Cold sticky sweat may be noted by palpation, as well as an increase in the patient’s pulse rate and its pathological characteristics - it is weakly filled, thread-like.

When percussing (tapping) the chest, a dullness of the percussion sound over the lung area will be noted (confirms that the lung tissue has an increased density).

Auscultation (listening to the lungs using a phonendoscope) reveals hard breathing and a mass of moist, large-bubble rales, first in the basal, then in all other parts of the lungs.

Blood pressure is often elevated.

Of the laboratory research methods for diagnosing pulmonary edema, the following are important:

• a general blood test will confirm the presence infectious process in the body (characterized by leukocytosis (increased number of leukocytes), with bacterial infection an increase in the level of band neutrophils, or rods, an increase in ESR).
• biochemical blood test - allows you to differentiate “cardiac” causes of pulmonary edema from causes caused by hypoproteinemia (decreased protein levels in the blood). If the cause of edema is myocardial infarction, the level of troponins and creatine phosphokinase (CPK) will be increased. Decreased blood levels total protein and albumin in particular - a sign that the edema is caused by a disease accompanied by hypoproteinemia. An increase in urea and creatinine levels indicates the renal nature of pulmonary edema.
• coagulogram (blood's ability to clot) - will confirm pulmonary edema resulting from pulmonary embolism; diagnostic criterion– increase in the level of fibrinogen and prothrombin in the blood.
• definition gas composition blood.

The patient may be prescribed the following instrumental methods examinations:

• pulse oximetry (determines the degree of oxygen saturation of the blood) - in case of pulmonary edema, its percentage will be reduced to 90% or less;
• determination of central venous pressure (CVP) values ​​is carried out using a special device - a Waldman phlebotonometer connected to the subclavian vein; with pulmonary edema, CVP is increased;
• electrocardiography (ECG) – determines cardiac pathology (signs of ischemia of the heart muscle, its necrosis, arrhythmia, thickening of the walls of the heart chambers);
• echocardiography (ultrasound of the heart) - to clarify the nature of the changes detected on the ECG or auscultation; thickening of the walls of the heart chambers, decreased ejection fraction, valve pathology, etc. can be determined;
• X-ray of the chest organs - confirms or refutes the presence of fluid in the lungs (darkening of the lung fields on one or both sides); in case of cardiac pathology - an increase in the size of the heart shadow.

Treatment of pulmonary edema

Pulmonary edema is a life-threatening condition for the patient, so at the first symptoms you must immediately call an ambulance.

During transportation to the hospital, the emergency medical team carries out the following: therapeutic measures:

• the patient is placed in a semi-sitting position;
• oxygen therapy with an oxygen mask or, if necessary, tracheal intubation and artificial ventilation;
• nitroglycerin tablet sublingually (under the tongue);
• intravenous administration of narcotic analgesics (morphine) - for the purpose of pain relief;
• diuretics (Lasix) intravenously;
• to reduce blood flow to the right side of the heart and prevent an increase in pressure in the pulmonary circulation, venous tourniquets are applied to the upper third of the patient’s thighs (preventing the disappearance of the pulse) for up to 20 minutes; remove the tourniquets, gradually loosening them.

Further treatment measures are carried out by specialists from the intensive care unit and intensive care, where strict continuous control over hemodynamic parameters (pulse and pressure) and breathing is carried out. Medicines usually administered through subclavian vein into which the catheter is inserted.

For pulmonary edema, the following groups of drugs can be used:

• to extinguish foam that forms in the lungs - so-called defoamers (oxygen inhalation + ethyl alcohol);
• with high blood pressure and signs of myocardial ischemia - nitrates, in particular nitroglycerin;
• to remove excess fluid from the body - diuretics, or diuretics (Lasix);
• for low blood pressure - drugs that increase heart contractions (Dopamine or Dobutamine);
• for pain - narcotic analgesics(morphine);
• for signs of pulmonary embolism - drugs that prevent excessive blood clotting, or anticoagulants (Heparin, Fraxiparin);
• for slow heart contractions - Atropine;
• for signs of bronchospasm - steroid hormones (Prednisolone);
• for infections - antibacterial drugs wide range actions (carbopenems, fluoroquinolones);
• for hypoproteinemia - infusion of fresh frozen plasma.

Prevention of pulmonary edema

Helps prevent the development of pulmonary edema timely diagnosis and adequate treatment of diseases that can provoke it.

Pulmonary edema is considered especially severe. Eat various ways solutions to this problem, but a large number of doctors advise resorting to folk medicine for pulmonary edema.

Causes and symptoms

Basically, this condition is not considered an independent disease. It most likely accompanies other pathological processes in the body. It is due to such changes that hypoxia occurs. Clinically it can manifest as cyanosis and suffocation.

The causes of this condition may be:

• diseases that are accompanied by a decrease in protein in the blood;
• diseases in which infection enters the bloodstream;
• pulmonary embolism;
• cardiovascular diseases which are characterized by blood stagnation;
• intravenous infusions of large volumes of fluids;
• overdose of some medical supplies;
• poisoning toxic substances;
• poisons;
• pulmonary diseases.

In general, symptoms appear quite abruptly and develop very quickly. The main signs of pulmonary edema are:

• pressing, squeezing pain in the chest caused by lack of oxygen;
• shortness of breath at rest, rapid breathing;
• a sharp feeling of lack of air;
• cardiopalmus;
• frequent coughing;
• blood pressure surges;
• discharge of foamy pink sputum when coughing;
• profuse sweating, blue or pale skin;
• confusion, agitation, fear of death, complete loss of consciousness, and subsequently coma.

How to relieve pulmonary edema at home

Traditional medicine is rich various recipes. They will help stop the attack and relieve symptoms. It must be remembered that adherence to the recipe and dosage must be very clear. There are some effective traditional methods, how to treat pulmonary edema folk remedies Houses.

Cherry

A decoction of cherry stalks will help relieve the condition. To prepare the product, take:

• 1 tablespoon cherry stems,
• a glass of boiling water.

Pour boiling water over the stalks and boil for a few minutes. Then let it cool. Take 3 times a day, 1/3 cup. Duration – 1-2 months.

Linen

Flax seeds also help with swelling. To prepare the product you need:

• 1 liter of water,
• 4 teaspoons flax seeds.

Pour water over the seeds and boil for 5 minutes. Remove the container from the heat and wrap it in a blanket. Let it brew for several hours. Then strain and add lemon juice to taste. Drink half a glass 5-6 times a day. The intervals between doses are 2-3 hours. Duration of treatment is a month. But the first results will be noticeable after the first second week.

Herbal infusions

Take in equal proportions:

• liquorice root,
• juniper fruits,
• lovage root,
• stelnik root,
• glass of water.

Mix all the herbs and pour cold water. Let stand for 6 hours. Then bring to a boil and simmer for another 15 minutes. Strain. Take a quarter glass four times a day.

You can cook another one medicinal collection. To do this you will need:

• St. John's wort herb,
• dog-rose fruit,
• nettle leaves,
• plantain leaves,
• bearberry leaf,
• 600 ml water.

Take all the herbs equally. Grind them and pour a tablespoon of the mixture with water. Boil for 5 minutes. Next, let it sit for about an hour and strain. Drink the resulting volume per day in 3-4 doses.

The effectiveness of use and such collection is noted:

• licorice root – 30 g,
• cornflower flowers – 30 g,
• bearberry leaves – 40 g,
• glass of water.

Mix everything and separate a tablespoon. Pour a glass of boiling water and leave for about a quarter of an hour. Take a tablespoon three times a day.

At treatment of pulmonary edema with folk remedies It is necessary to observe the reaction of your body to taking decoctions. It is necessary to consult a doctor before starting therapy.

Pulmonary edema is a life-threatening, very severe and acute painful condition associated with abnormal accumulation of intercellular (interstitial) fluid in the lung tissue and inside the alveoli. That is, instead of the air that should get into the lung sacs, water penetrates them, and the person, unable to breathe, literally chokes and dies. Therefore, in this article we will consider the causes, consequences and timing of treatment of pulmonary edema in an adult and child, its symptoms and signs, algorithm emergency care.

What is pulmonary edema

Pulmonary edema is expressed as a sudden and acute feeling of lack of air, which accompanies suffocation and (blue) skin. An abnormal amount of fluid in the lungs leads to a sharp disruption of its proper circulation, disruption of the gas exchange process, and a decrease in respiratory function and the rapid development of oxygen deficiency in the structures of the heart, since the full supply of air to the cells of the lungs, the saturation of the blood with oxygen, as well as the process of removing toxic metabolic products from the cells are disrupted.

Its varieties

There are two basic types of edema, which are associated with the causative factor:

Two forms (and stages) of the pathology are differentiated:

• Interstitial. The abnormal process in the lungs begins to progress when the volume of transudate increases, which is released from small vessels into the space between the cells of the lung tissue. After this, the metabolic process, cell and vascular functions are disrupted.
• Alveolar. This is the late stage of edema, when fluid has leaked through the capillary walls into the area between tissue cells, penetrates the pulmonary alveoli. In conditions when all the alveolar vesicles are filled with liquid, the act of breathing is interrupted, oxygen does not fill the lungs - the body dies.

Depending on the rate of deterioration of the patient’s condition and the increase in symptoms, certain stages are distinguished:

In chronic pathologies, swelling often occurs at night, which is associated with a long lying position. In case of thromboembolism (blocking by a blood clot main vessel heart or lungs), the patient’s condition deteriorates sharply at any time.

Now let's talk about the symptoms of pulmonary edema in heart failure and other cardiac problems.

How to identify a symptom in yourself

With fulminant edema, all symptoms of the pathology develop suddenly, rapidly increasing, and it is often impossible to save the patient. In a prolonged form, the development of all symptoms of edema does not occur so quickly, so there is a real chance to help the patient. The process of deterioration depends on the rate of transition from the interstitial form of edema to the alveolar one.

Primary signs

Primary signs of an impending threat (usually at the interstitial stage):

• pressing, squeezing pain in the chest due to an acute lack of oxygen, as happens when drowning;
• an increase in the number of respiratory movements, an increase in symptoms (dyspnea) at rest with difficulty in both inhalation and exhalation;
• severe (abnormally rapid heartbeat, from 120 beats per minute);
• increase in the volume of dry wheezing with the gradual appearance of wet wheezing.

Further progression of the pathology

Further progression of the pathology (transition to the alveolar form):

• paroxysmal feeling of suffocation, which intensifies if the patient lies on his back; for this reason, patients try to sit down and lean forward, resting on their palms (orthopnea);
• breathing quickens even more, becomes shallow;
• an abundance of moist rales, bubbling and audible at a distance;
• the skin becomes covered with sticky perspiration with cold drops of sweat;
• The skin tone becomes earthy, gray-purple with the network of subcutaneous vessels showing through;
• The mouth begins to produce foamy sputum, often pinkish in color due to the ingestion of red blood cells (in severe cases, foam comes through the nose).

Foaming in a volume of up to several liters occurs when the extracellular fluid filling the lung vesicles reacts with air and surfactant, a substance lining the alveoli from the inside. At the same time, the process of oxygen saturation of the blood practically stops, and asphyxia occurs. The patient is suffocating and gasping for air.

• Perception is disrupted, blood pressure drops, it becomes, a panic state develops with fear of death, with the transition to a coma.

Read below about the causes of pulmonary edema.

What diseases and disorders may the symptom indicate?

Pulmonary edema is not a separate issue pathological processes, occurring in isolation, but represents a serious complication that has reached critical stage internal diseases. The etiology (origin) of edema is very different, and the pathogenesis is not fully understood.

However, in therapy, a special group is allocated internal illnesses, in which edema especially often develops:

1. Severe heart disease with dysfunction of the left ventricle (ventricular infarction) and blood retention in the small (pulmonary) circulation - the vascular path from the right ventricle through the lungs to the atrium and back: with, (abnormal proliferation of connective tissue replacing the working muscle fibers myocardium), atrial fibrillation, heart block.
2. Defects of heart structures. Of these, the most common is and.
3. (damage and rupture).
4. Pneumothorax(penetration of air into the pleural space during injury);
5. Acute dysfunction (impaired functioning) of the respiratory center(asthmatic status, obstruction of the respiratory tract by a foreign object).
6. of different origins.

In addition, pathology is observed when following conditions and states:

• pneumonia, progressive pulmonary emphysema, severe, long-term intractable asthmatic attack;
• introduction of pyogenic bacteria into the general bloodstream (blood poisoning or sepsis);
• severe poisoning, infections;
• anaphylactic shock in acute allergies to medications, foods, chemicals;
• lesions of the central nerve trunks;
• (blockage of the lumen of a vessel with a thrombus);
• diseases that provoke a decrease in the amount of protein in the blood (, illness or weak activity kidney).

Pulmonary edema can develop under the following conditions:

• intravenous infusions of large volumes of drugs without stimulating urination;
• taking excessive doses of certain medications (beta blockers; Apressin);
• radiation damage to lung tissue, drug use, drowning, being at high altitudes.

How to deal with it

Pulmonary edema is a condition that poses an extreme threat to life, often resulting in the death of a person, therefore, at the most initial manifestations breathing disorders (especially with cardiac and pulmonary diseases) you must immediately call an ambulance or mobile intensive care unit. Therefore, let's find out what the emergency care for pulmonary edema is and what the algorithm of action is.

Urgent Care

The first measures that relatives, colleagues, friends and passers-by take in case of pulmonary edema before the ambulance arrives:

1. If the person has not lost consciousness, he is carefully seated so that rib cage assumed a vertical position.
2. Open the windows (in warm time), vents - in the cold.
3. Unbutton all items of clothing that put pressure on the chest and tighten the stomach (ties, belts, belts, jeans that are tight at the waist; for women, cut the dress if it is too tight on the chest).
4. The patient is given a tablet to dissolve (under the tongue) to remove excess fluid from the swollen tissues.
5. Provide a person with the opportunity to breathe through alcohol vapor to extinguish the release of foam. In a home, office, or street environment, you can soak gauze with 96% alcohol so that a person can breathe through it.

It should be clearly understood that nitroglycerin often causes a sharp and very deep drop in pressure and loss of consciousness, which will aggravate the situation. Therefore, any drugs with nitroglycerin are given with constant monitoring of blood pressure.

It is best to use sublingual sprays (Nitrosprey,), which are more effective in an emergency - the onset of the effect of the drug is accelerated, and the dose is easier to vary than when taking tablets.

Hospital treatment

Specialists are taking the following measures:

1. They ensure saturation of the lungs and blood with oxygen by performing oxygen inhalations (100%) through a 96% alcohol solution, introducing cannulas into the nasal passages or applying a mask to destroy foam formation. In a particularly threatening situation, tracheal intubation is performed, mechanical ventilation is performed - forced ventilation lungs.
2. An intravenous injection of morphine hydrochloride 2–5 mg is given (if necessary, after 10–20 minutes, again). Morphine relieves overexcitation of the nervous system and fear of death, manifestations of shortness of breath, dilates the blood vessels of the heart, brain, lungs, and lowers blood pressure in the central artery of the lungs. The opiate is not used for low blood pressure and obvious respiratory distress. If the patient's breathing is depressed, a morphine antagonist, Naloxone, is prescribed.
3. Gently pressing tourniquets are applied to the upper third of the thighs (making sure that the pulse is felt), removing them after 10 - 20 minutes, slowly releasing the pressure. This is done to reduce blood flow to the right chamber of the heart and reduce pressure.
4. Nitroglycerin is used cautiously in patients with symptoms of myocardial ischemia (death of cells due to impaired blood flow to them) and to activate the heart’s work to pump blood. First, 0.5 mg is given to the patient under the tongue (into the mouth previously moistened with water, since swelling causes the mucous membranes to dry out). After this, the drug is slowly injected into a vein through a dropper (1% solution) no faster than 15 - 25 mcg per minute, gradually increasing the dose. All activities are carried out while constantly monitoring blood pressure (not allowing systolic pressure to drop below 100 - 110).
5. When cardiogenic shock develops, Dobutamine is used intravenously (50 mg in a solution of sodium chloride in a volume of 250 ml), which increases the volume of cardiac output, strengthens the contraction of the heart muscle, increases blood pressure to normal levels. Has a specific and useful property- together with active stimulation of myocardial contractions, expand the vessels of the heart, brain, kidneys, intestines, improving circulation in them. Dobutamine is administered through an IV at 175 mcg per minute with a slow increase in dose to 300.
6. Be sure to carry out diuretic therapy to increase diuresis and reduce stagnation venous blood in the lungs and expand capacitive (venous) vessels to reduce the load on the heart. Furosemide is prescribed intravenously at a dosage of 40–60 mg, gradually increasing the dose to 200 mg, Bumetamide, Burinex (1–2 mg), Lasix (40–80 mg).
7. In case of severe increase in heart rate, atrial fibrillation, cardiac glycosides are used by administering intravenously a 0.05% solution (in a volume of 0.5 - 0.75 ml), 0.025% (0.5 - 0.75 ml) with 5% glucose or sodium chloride. But glycosides are not used during acute cardiac infarction, with narrowing or fusion of the atrioventricular opening, with increased pressure, since they can cause reverse reactions, leading through certain physiological mechanisms to worsening the edema condition. Therefore, the worse the condition of the heart muscle, the more carefully cardiac glycosides are used.
8. for (dangerous slowing of heart contractions) - Atropine.

Bleeding up to 500 ml in practice modern medicine is no longer used to relieve pulmonary edema, but this technique is effective and may be the only salvation in circumstances where there are no other medical options.