Pulmonary Edema Associated with Tocolytic Therapy

Pisani, Richard J.; Rosenow, Edward C.

doi:10.7326/0003-4819-110-9-714

Cited by 123 publications

(36 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, we believe that cyclosporine played no consistent role. Intravenous steroids have rarely been associated with pulmonary edema, and then only in association with high-dose intravenous β 2 -agonists in parturient women [11, 12]. Their role in the present case is, therefore, elusive.…”

Section: Discussionmentioning

confidence: 77%

“…The histopathologic background of the transient pulmonary opacities seen in our case remains unclear, as the mildness of the clinical picture did not justify a lung biopsy. Similarly, the administration of several drugs (mostly aspirin [26], but also hydrochlorothiazide [27], nitrofurantoin [28], or β 2 -agonists [12, 29]) can induce transient, rapidly evolving pulmonary infiltrates, thought to reflect pulmonary edema [7]. In most of these cases, no histology was available.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transient Pulmonary Infiltrates during Treatment with Anti-Thymocyte Globulin

Maillard

Foucher²,

Caillot³

et al. 1999

Respiration

View full text Add to dashboard Cite

We report the case of a 54-year-old woman with aplastic anemia, who developed transient pulmonary infiltrates following intravenous infusion of rabbit antithymocyte globulin (ATG) for 3 days. There was no other explanation than the infusion of ATG for the infiltrates. Rechallenge with ATG induced the recurrence of opacities on the chest radiograph. Although rarely involved with only 4 previous reports, ATG should be included in the list of drugs capable of inducing pulmonary infiltrates.

show abstract

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Transient Pulmonary Infiltrates during Treatment with Anti-Thymocyte Globulin

Maillard

Foucher²,

Caillot³

et al. 1999

Respiration

View full text Add to dashboard Cite

show abstract

“…2,9,14 Most of the present cases were of cardiogenic origin or caused by volume overload, which increases hydrostatic pressure, and the pulmonary edema resolved rapidly with treatment. The mean number of days taken for resolution was 2.2 days, which is very similar to a previous study.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Edema During Pregnancy. Unilateral Presentation Is Not Rare.

Choi

Han

et al. 2002

Circ J

View full text Add to dashboard Cite

uring the past 20 years, the incidence, 1,2 cause and associated clinical conditions, 2-8 and clinical course 2,9 of obstetric pulmonary edema have been reported. Pulmonary edema during pregnancy can be lifethreatening and patients are usually transferred to tertiary care centers, so most of the medical literature is based on the experiences of the tertiary care centers. Hence, there is limited information on the natural history of pulmonary edema from its onset to its resolution because of a possible selection bias in previous studies.The primary purpose of our study was therefore to determine the incidence, etiology and course of pulmonary edema in all obstetric patients at our primary -secondary care center during the past 3.5 years. We analyzed (1) the clinical conditions associated with the onset of pulmonary edema, (2) the etiologic diagnosis made by echocardiography within 2 days of onset and (3) the X-ray pattern and rate of resolution. MethodsWe studied prospectively patients with pulmonary edema among 29,621 obstetric cases at the Samsung Cheil Hospital and Women's Healthcare Center between March 1, 1998 and June 31, 2001. Pulmonary edema was diagnosed on the basis of a history of dyspnea, pulmonary rales, hypoxemia (PaO2 <80 mmHg or SataO2 <90% with room air), and airspace opacities on the chest radiograph consistent with Circulation Journal Vol.66, July 2002 pulmonary edema. Cases of initially atypical X-ray presentation were also included when clinical symptoms and signs and the X-ray infiltration improved rapidly with treatment for pulmonary edema such as diuretics, inotropics, or both.We collected data from the time when pulmonary edema was suspected. The chest was radiographed and pulse oximetry was monitored for all patients with severe dyspnea and pulmonary rales. To elucidate the cause we reviewed the medical history for the presence of pre-existing cardiac or hypertensive disease, diagnosis of twin gestation, preterm labor, pre-eclampsia, treatment with steroids, MgSO4 ormimetics, evidence of infection, and volume overload. Within 2 days of the onset of pulmonary edema, 2-dimensional and M-mode echocardiography with Doppler study were performed using a Hewlett-Packard (Sonos 1000, USA) echocardiograph to assess left ventricular systolic and diastolic function. Peripartum cardiomyopathy was diagnosed on the basis of the echocardiographic findings. 10 Diastolic heart failure was diagnosed from a transmitral flow study when the E/A ratio was less than 1 in the presence of a deceleration time (DT) greater than 220 ms, or if the isovolumetric relaxation time (IVRT) was greater than 100 ms with normal systolic function. 11 Pre-eclampsia was diagnosed on the basis of ACOG clinical criteria. 12 During treatment of pulmonary edema, a chest X-ray was performed every 1 or 2 days. When patients were transferred to tertiary centers, we obtained follow-up information from the doctors by telephone contact. ResultsPulmonary edema developed in 18 cases (0.06%) of all obstetric patients (Table 1). The mean ma...

show abstract

“…Pro longed exposure to corticosteroids, beta 2-agonists causes left ventricular dysfunction causing pulmonary oedema. 28 Diagnosis of tocolytic induced pulmonary oedema is based on clinical presentation in appropriate setting of tocolytic use. No specific investigation establishes diagnosis of tocolytic induced pulmonary oedema.…”

Section: Tocolytics and Pulmonary Oedemamentioning

confidence: 99%

Respiratory diseases in pregnancy

Raghu¹,

Pulivarthi²

2015

J Clin Sci Res

View full text Add to dashboard Cite

Pulmonary diseases are one of the major indirect causes of maternal deaths. Pregnancy is a unique physiologi-cal state during which changes occur in all systems of the body to meet metabolic needs of both the mother and growing foetus. Enlarging uterus and increasing hormonal levels cause changes in volumes and mechanics of lungs. Understanding the basic physiology of the cardiovascular and respiratory changes during pregnancy along with the pathology of disease processes are vital in making therapeutic decisions. Pre-existing conditions like asthma, tuberculosis, and acute illnesses like pneumonia, acute respiratory distress syndrome (ARDS), pneumothorax can have calamitous effect on mother and child health. Continual foetal monitoring throughout pregnancy is very important in early recognition of foetal jeopardy.

show abstract

Pulmonary Edema Associated with Tocolytic Therapy

Abstract: Familiarity with the clinical features outlined above should increase the internist's ability to manage this problem without further invasive or noninvasive testing that might otherwise be used in evaluating dyspnea in pregnancy.

Cited by 123 publications

References 21 publications

Transient Pulmonary Infiltrates during Treatment with Anti-Thymocyte Globulin

Transient Pulmonary Infiltrates during Treatment with Anti-Thymocyte Globulin

Pulmonary Edema During Pregnancy. Unilateral Presentation Is Not Rare.

Respiratory diseases in pregnancy

Contact Info

Product

Resources

About