Gravitational Edema of the Lungs Observed During Assisted Respiration

Leeming, B. W. A.

doi:10.1378/chest.64.6.719

Cited by 36 publications

(11 citation statements)

References 3 publications

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“…The increase in hydrostatic pressure in the dependent lung parenchyma is due to increased circulating intravascular volume and also to gravity. Dependent lung parenchyma has a relative hyperperfusion and hypoventilation, especially in our case context of volume overload may result in pulmonary edema [6]. The immediate resolution of pulmonary edema with dialysis further supports this pathogenesis.…”

Section: Discussionsupporting

confidence: 64%

Acute Unilateral Pulmonary Edema in Non-Cardiac Settings

Omran

2014

J Med Cases

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Unilateral pulmonary edema is an uncommon manifestation of pulmonary edema. We report a case of unilateral pulmonary edema in a 45-year-old woman with chronic kidney disease, hypertension and diabetes who presented after a motor vehicle collision and was down with the left lung in dependent position. She was found to have a left lung infiltrate on the chest computed tomography (CT) scan. Resolution of radiological findings after hemodialysis pointed toward pulmonary edema. The patient did not have any pre-existing parenchymal lung abnormality; therefore the cause of pulmonary edema was ascribed to dependent position.

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Section: Discussionsupporting

confidence: 64%

Acute Unilateral Pulmonary Edema in Non-Cardiac Settings

Omran

2014

J Med Cases

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“…16 In our population of patients with cardiogenic pulmonary edema, we found an estimated UPE prevalence of 2.1%, showing that UPE is not as unusual as presumed. Vascular or bronchial obstruction, congenital heart disease, and prolonged rest on one side may induce UPE, 4,5,17,18 but severe MR remains the main cause of UPE. 9,10 In our study, UPE was always associated with severe MR and represented 25% of pulmonary edema with severe MR. Two previous studies found that 9% and 22% of patients presenting with severe MR and signs of congestive heart failure had radiological signs of UPE, mainly in the right upper lobe.…”

Section: Discussionmentioning

confidence: 99%

“…The unilateral location of cardiogenic pulmonary edema is unusual [3][4][5][6][7][8] and has rarely been described and mainly reported in association with severe mitral regurgitation (MR). 9,10 Little is known about the characteristics of unilateral pulmonary edema (UPE), and its prevalence has never been assessed in a large series of pulmonary edema.…”

Section: Clinical Perspective On P 1115mentioning

confidence: 99%

Prevalence, Characteristics, and Outcomes of Patients Presenting With Cardiogenic Unilateral Pulmonary Edema

et al. 2010

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Background-Cardiogenic unilateral pulmonary edema (UPE) is a rare entity, frequently leading to initial misdiagnosis.We sought to assess the prevalence of UPE and to determine its impact on prognosis compared with bilateral pulmonary edema. Methods and Results-We studied the characteristics and outcomes of patients admitted to our institution for cardiogenic pulmonary edema during an 8-year period. The study population included 869 consecutive patients. The prevalence of UPE was 2.1%: 16 right-sided UPE (89%) and 2 left-sided UPE (11%). In patients with UPE, blood pressure was significantly lower (PՅ0.01), whereas noninvasive or invasive ventilation and catecholamines were used more frequently (Pϭ0.0004 and PϽ0.0001, respectively). The prevalence of severe mitral regurgitation in patients with bilateral pulmonary edema and UPE was 6% and 100%, respectively (PϽ0.0001). In patients with UPE, use of antibiotic therapy and delay in treatment were significantly higher (PϽ0.0001 and Pϭ0.003, respectively). In-hospital mortality was 9%: 39% for UPE versus 8% for bilateral pulmonary edema (odds ratio, 6.9; 95% confidence interval, 2.6 to 18; PϽ0.001). In multivariate analysis, unilateral location of pulmonary edema was independently related to death whatever the model used (adjusted odds ratio, 6.5; 95% confidence interval, 1.3 to 32; Pϭ0.021 for model A; and adjusted odds ratio, 6.8; 95% confidence interval, 1.1 to 41; Pϭ0.037 for model B). Conclusions-Unilateral pulmonary edema represented 2.1% of cardiogenic pulmonary edema in our study, usually appeared as an opacity involving the right lung, and was always associated with severe mitral regurgitation. Unilateral pulmonary edema is related to an independent increased risk of mortality and should be promptly recognized to avoid delays in treatment. (Circulation. 2010;122:1109-1115.)

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“…To explain unilateral pulmonary edema, we must postualte the existence of a set of factors-extrapulmonary, pulmonary, or pleural-preventing the pressure modification from being expressed bilaterally. 3 Leeming 8 found that in patients treated with positive pressure ventilation, there was a significant positive correlation between the position of the patient and the localization of edema. One of the effects of gravity is to cause variations in pulmonary venous pressure in the presence of congestive heart failure or mitral stenosis.…”

Section: Discussionmentioning

confidence: 99%