Neurogenic pulmonary edema

Tan, Che-Kim; Lai, Chih-Cheng

doi:10.1503/cmaj.061584

Cited by 13 publications

(3 citation statements)

References 2 publications

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“…Other studies have reported that over 50% of NPE are resolved within 72 hours [25,26]; In our study, 6 of 11 cases were resolved within 72 hours. However, three cases showed a duration of more than 10 days, and in some cases, it lasted up to 58 days.…”

Section: Discussionsupporting

confidence: 56%

Neurogenic pulmonary edema and Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage

Hwang,

Koo,

Lee

et al. 2023

Acta Neurochir

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Objective: Neurogenic pulmonary edema (NPE) combined with Takotsubo cardiomyopathy (TCM) is a unique condition associated with aneurysmal subarachnoid hemorrhage (aSAH). Although several mechanisms have been proposed, the pathophysiology and management strategies are not yet fully established. We aimed to determine the radiological and clinical outcome of patients with NPE with TCM after aSAH and to propose management strategies.Methods: We analyzed the data of 573 patients with aSAH recorded at a single medical center from February 2015 to July 2022. This study retrospectively investigated the incidence and demographics of SAH combined with both NPE and TCM and the clinical outcomes of the patients. Risk factors of NPE-TCM were also investigated.Results: During the 7 years, 11 (1.9%) of 513 patients had NPE complicated with TCM after aSAH. All 11 patients had poor-grade SAH (Hunt-Hess Grade 3 to 5). Three of 11 patients had posterior circulation in the NPE-TCM group. The most prevalent treatment option was endovascular coil embolization except for one case of clip. Longterm outcomes were favorable in 6 of 11 patients, and there was one case of mortality. Age, troponin I level, and alveolar-arterial oxygen gradient were risk factors of NPE-TCM.Conclusion: NPE combined with TCM is a unique nding in patients with aSAH, and severe clinical conditions may be independent predictors of a fatal outcome. Therefore, understanding the pathophysiology and appropriate management of this condition can improve outcome in patients with aSAH.

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Section: Discussionsupporting

confidence: 56%

Neurogenic pulmonary edema and Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage

Hwang,

Koo,

Lee

et al. 2023

Acta Neurochir

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“…Improvements in mechanical, pharmacological and therapy based regimes are the likely reason pulmonary embolism is now a relative rarity. Cardiac failure and very rarely neurogenic pulmonary oedema [69, 70] are among the other causes.…”

Section: Causes Of Hypoxia In Acute Strokementioning

confidence: 99%

Hypoxia after stroke: a review of experimental and clinical evidence

Ferdinand

Roffe

2016

Exp & Trans Stroke Med

104

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BackgroundHypoxia is a common occurrence following stroke and associated with poor clinical and functional outcomes. Normal oxygen physiology is a finely controlled mechanism from the oxygenation of haemoglobin in the pulmonary capillaries to its dissociation and delivery in the tissues. In no organ is this process more important than the brain, which has a number of vascular adaptions to be able to cope with a certain threshold of hypoxia, beyond which further disruption of oxygen delivery potentially leads to devastating consequences. Hypoxia following stroke is common and is often attributed to pneumonia, aspiration and respiratory muscle dysfunction, with sleep apnoea syndromes, pulmonary embolism and cardiac failure being less common but important treatable causes. As well as treating the underlying cause, oxygen therapy is a vital element to correcting hypoxia, but excessive use can itself cause molecular and clinical harm. As cerebral vascular occlusion completely obliterates oxygen delivery to its target tissue, the use of supplemental oxygen, even when not hypoxic, would seem a reasonable solution to try and correct this deficit, but to date randomised clinical trials have not shown benefit.ConclusionWhilst evidence for the use of supplemental oxygen therapy is currently lacking, it is vital to rapidly identify and treat all causes of hypoxia in the acute stroke patient, as a failure to will lead to poorer clinical outcomes. The full results of a large randomised trial looking at the use of supplemental oxygen therapy are currently pending.

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“…Rare causes include multiple sclerosis, brain tumor, encephalitis, cervical spine injury, and ischemic stroke. [14] The etiology is proposed to be related to a catecholamine surge associated with significant CNS injury that results in cardiopulmonary dysfunction, increased pulmonary hydrostatic pressure, and increased lung capillary permeability related to the inflammatory response. Two distinct clinical forms-cardiogenic and noncardiogenic-have been proposed, distinction between which may have a therapeutic implication.…”

Section: Clinical Pulmonary Infection Scorementioning

confidence: 99%

Pulmonary complications in neurosurgical patients

Guleria¹,

Madan²

2012

IJNS

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Pulmonary complications are a major cause of morbidity and mortality in neurosurgical patients. The common pulmonary complications in neurosurgical patients include pneumonia, postoperative atelectasis, respiratory failure, pulmonary embolism, and neurogenic pulmonary edema. Postoperative lung expansion strategies have been shown to be useful in prevention of the postoperative complications in surgical patients. Low tidal volume ventilation should be used in patients who develop acute respiratory distress syndrome. An antibiotic use policy should be put in practice depending on the local patterns of antimicrobial resistance in the hospital. Thromboprophylactic strategies should be used in nonambulatory patients. Meticulous attention should be paid to infection control with a special emphasis on hand-washing practices. Prevention and timely management of these complications can help to decrease the morbidity and mortality associated with pulmonary complications.

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Neurogenic pulmonary edema

Cited by 13 publications

References 2 publications

Neurogenic pulmonary edema and Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage

Neurogenic pulmonary edema and Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage

Hypoxia after stroke: a review of experimental and clinical evidence

Pulmonary complications in neurosurgical patients

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