Pulmonary edema is a serious condition that threatens not only health, but also human life. It can arise for a number of reasons in people of almost any age, but always accompanied by a number of characteristic symptoms.
In time to notice that the lungs swell, recognize the symptoms - this can be handled not only by a professional physician, but also a person without special education, attentive to himself and his loved ones.
Mechanism of edema development
Normally, lung tissue consists of a multitude of smallest,air bubbles - the alveoli. If, in addition to air, the fluid starts to accumulate in the alveoli - as a result of sweating it from the circulatory and lymphatic system - pulmonary edema occurs.
The mechanism of this pathological condition is as follows:
- As a result of stagnant phenomena in the small pulmonary circulatory system, the outflow of blood and lymph is disrupted and there is an increase in intravascular pressure in the pulmonary capillaries and lymphatic vessels.
- Blood and lymph accumulate in the vessels and begin to penetrate through their walls into the pulmonary structures of the alveoli - a so-called fluid effusion occurs.
- The liquid or transudate permeated into the alveoli displaces air from them and significantly reduces their respiratory surface. The situation is exacerbated with the increase in the amount of transudate in the lungs - the effect of "internal drowning" is observed, when the lungs are filled with water and can not function fully.
- The transudate is very rich in protein and therefore easily foams when it comes in contact with air in the alveoli. The resulting foam further complicates the breathing process.
- As a result, breathing becomes almost impossible, oxygen does not enter the blood, hypoxia and death occur.
Causes of pulmonary edema may be:
1. Cardiogenic - that is, associated with heart and vascular diseases: acute heart attack, heart defects, cardiosclerosis, severe degree of hypertension. In this case, stagnation in the small circle of blood circulation arises because the heart does not cope with its functions and is not able to fully pump blood through the lungs.
2. Non-cardiogenic :
- Hydrostatic edema occurs due to increased intracapillary pressure in the lungs as a result of pulmonary embolism, pneumothorax, tumors, bronchial asthma, ingestion of foreign objects;
- Membrane-induced edema develops as pulmonary capillary permeability increases as a result of respiratory distress syndrome( sepsis, chest trauma, pneumonia), aspiration syndrome( vomit or water enter the lungs), inhalation and intoxication syndromes( poisoning, includingendotoxins).
Symptoms: from the first signs to the dangerous form
The signs of pulmonary edema in an adult are such symptoms and signs:
- the appearance of dyspnoea and asthma that do not depend on physical exertion;
- cough or discomfort behind the breastbone at the slightest physical exertion or lying down;
- orthopnea - the forced vertical position of the patient, which he takes because lying can not fully breathe.
As the edema and dysfunction of an ever increasing lung area increase, the patient's condition deteriorates rapidly and can first appear "blue" and then "gray" hypoxia:
| Symptoms of | "Blue" hypoxia | "Gray" hypoxia |
| General condition of | Severe, severe weakness and anxiety. Consciousness is preserved. Forced vertical position of the body. There are swollen vessels on the neck. There may be nausea and vomiting, high fever. | Extremely heavy. Consciousness is confused until its complete loss. Apathy. |
| Pain localization | Behind the sternum | Severe compressive pain behind the sternum |
| Respiration | Difficult, frequent( 30-60 per minute) and superficial | Rare and arrhythmic. Rattles in the lungs are heard. |
| Cough | At first dry and painful, then with abundant foam-phlegm. Sensation of bubbling fluid inside. | With a rich foamy liquid of a pinkish hue. |
| Skin and mucosa condition | Mucous membranes and skin on fingers blue | Skin of earthy shade, covered with cold sweat |
| Pulse | Frequent, up to 100 per minute, but weak | Weak, practically not palpable |
| Urination | Very rare, down to total absence | Absence |
| Forecast | With timely care of a favorable | Adverse |
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How to find out in time, not to be confused with other diseases
If the edema develops gradually, then the stage of imaginary well-being can take about a day.
Sometimes the pathology of occurs in the erased form of , in which hypoxia is not strongly pronounced. More often it happens in patients with acute myocardial infarction.
Anxiety symptoms that require immediate medical attention are:
- dyspnea at rest;
- shortness of breath, while the patient complains of a feeling of "bubbling" in the chest;
- inability to breathe in "full breast" - when trying to do so the patient coughs and feels pain;
- increased respiration - as compensation for its inadequate depth;
- feeling of compression and discomfort behind the sternum;
- dry, persistent cough;
- impossibility to lie down - in a horizontal position the patient becomes worse;
- weakness and weakness;
- blue lips and fingertips.
How to help the patient - what can and can not be done
The algorithm for the first emergency care for pulmonary edema consists in performing the following urgent measures:
- Call an ambulance .You can not ignore complaints and wait for a worsening of the condition - pulmonary edema can lead to a fatal outcome almost instantaneously.
- Sick to soothe : use valerian or motherwort.
- Unbutton all clothing that is tight in breath.
- Sit on a chair, lower your legs down .You can not put this patient in a horizontal position.
- Before arrival of the physician, you can apply tourniquets to the limbs that pinch the veins. It is important in this case not to allow the disappearance of the pulse on the clamped limb. The plaits are applied for 15-20 minutes, then they are removed. After a while they can be applied again. Thus, the heart is unloaded - it takes less effort to pump blood to the periphery of the body.
- You can give the patient 1 tablet of nitroglycerin sublingually.
- If possible, use an oxygen mask.
- If a large amount of foam separates during coughing - use defoamers. At home, it can be ordinary alcohol: a nose towel and mouth of the patient periodically apply a towel soaked in vodka or medical alcohol. Expectorants better not to use if the cough has already become wet with abundant phlegm.
- To prevent edema - should warm the back of the patient : put mustard plasters.
It is important not to ignore the first symptoms of pulmonary edema, and to take timely measures to eliminate and professional treatment in a hospital.