Understanding Pulmonary Edema: Causes, Symptoms, and Treatment

Diseases such as heart failure, kidney failure, pneumonia, and cancer may all cause pulmonary edema. The 90-year-old national treasure artist “Offline” Chen Bingnan was also hospitalized due to lung infection leading to pulmonary edema. However, the mortality rate of pulmonary edema is quite high, and once it occurs, he may be hospitalized immediately. In the following treatment days, please ask Tu Chuanzhou, Vice President of Department of Chest Medicine, Yuanrong Hospital, to explain the causes of pulmonary edema, high-risk groups, symptoms and treatment/prevention of pulmonary edema.

What is hydropneumonitis? Is the death rate high?

The lungs are like elastic and soft sponges with many holes. The gaps allow air to stay and circulate oxygen, carbon dioxide and other gases. Once hydrops occurs in the lungs, it is like a sponge full of water. The original holes are filled with liquid, which cannot Inhalation of oxygen and discharge of carbon dioxide will result in a hypoxic state, and the patient will soon suffer from anoxic coma and die.

Although the death rate is very high when hydropneumonia is severe, most patients with hydropneumonia can be saved unless the patient has no sense of illness and does not receive timely treatment. Generally, there are not many cases of death due to hydropneumonia in clinical practice.

What are the causes of pulmonary edema?

Why does it cause a large amount of fluid to accumulate in the lungs? It may be the backflow of blood from the heart, or the increased permeability of the lungs, resulting in a large amount of water leakage, which makes the pressure of the lungs too high and the water that should not come out is squeezed into it.

The first common cause is heart failure, whether it is insufficient diastolic or contractive strength of the heart, as long as the blood fills the heart, it will flow back into the connected lungs and become pulmonary edema, which is the most common cause. The second most common is kidney disease, such as kidney failure, which results in excess water in various organs in the body, including the lungs. Other causes include tumors in the lungs and lung infections, which change the permeability of the lungs and cause a lot of water to leak out of the lungs. Another rare cause of pulmonary edema is that the patient’s nutrition is too poor. At this time, it is easy for water to leak into the lungs.

What are the symptoms of hydropneumonia? What situation should see a doctor as soon as possible?

Generally, it is chest tightness and wheezing at the beginning, and when it is more severe, the wheezing is even worse when lying down. You can only sit up quickly to relieve the discomfort, so many patients have to sit and sleep. If it gets worse, the blood oxygen concentration will decrease, resulting in hypoxia, even cyanosis, and black lips, hands and feet. The most serious situation is hypoxic coma, at which point it is necessary to use a machine to open the lungs urgently, and it is a race against time.

How is hydropneumonitis diagnosed?

The doctor will ask the patient if he has less urination recently, listen to the lungs with a stethoscope for “pulmonary rales” (sounds like the sound of a plastic bag being blown), and then check for edema in the hands and feet, and the veins in the neck. Whether there is a big drum and other situations to make a comprehensive judgment.

The most important examination is X-ray. If there is a white misty butterfly-shaped infiltration in the lungs, it may be hydropneumonia. The most serious thing is that pink bubbly secretions (bubble phlegm) will be spit out when the mouth is intubated. It is a typical symptom of pulmonary edema.

(Source of X-ray pictures of pulmonary effusion: Yuanrong Hospital)

Who are the high-risk groups for hydropneumonia?

1. People with bad heart: Patients with chronic heart disease, especially high blood pressure that has not been well controlled for a long time, will have poor contraction or relaxation force, or heart valve problems, which will increase the risk of pulmonary hydrops.
2. People with poor kidneys: people with kidney disease, people who often take painkillers and their kidneys are damaged
3. People with poor immunity: the elderly, diabetic patients, etc., the lungs are prone to infection
4. lung cancer patients
5. people who eat too much salt
6. People who often drink a lot of water and have poor urination
7. old smoking gun

Further reading: Clear sputum is actually a warning sign of lung cancer!Famous doctors share regrettable cases: cough with thin sputum fears lung cancer symptoms

Will hydropneumonia get better? How to treat it?

As long as the source of the disease is found, pulmonary edema can be cured. For example, if the source of the disease is heart failure, seek help from a cardiovascular disease expert to cure the heart problem and improve the function of the heart; if the kidney is not good, you can first use diuretics to drain water, or even dialysis. The kidney problem must be cured In order to improve the hydrops in the lungs; if the lungs are infected or even lung cancer, they should be cured quickly and the focus of the disease should be resolved. Patients also need to take good water control and low-sodium diet at ordinary times. As long as the right medicine can be prescribed, pulmonary effusion will probably not be fatal, and there is a chance of recovery.

Reminders for treatment days: prevent pulmonary hydrops, pay attention to sodium intake, air pollution

Whether it is high blood pressure or valve problems, heart function will be relatively poor, or kidney problems, these patients will follow the doctor’s advice to treat the disease, and follow up regularly, do a good job of diet control, pay special attention to sodium intake; if the kidneys are not good People who are sick must pay special attention to whether the medicines they take may damage the kidneys. If you have a lung infection or tumor, you should pay more attention to air pollution. If you have a smoking habit, you should try your best to quit smoking. If you have a family history of lung cancer, you should do regular lung screening and early treatment.

For the part of lung infection, it is necessary to strengthen the body’s resistance, especially for the elderly or those with poor immunity, it is best to take the Streptococcus pneumoniae vaccine and the autumn and winter flu vaccine every year to protect the lungs and reduce the chance of infection.

Treatment day extension recommendation: Cutting food into small pieces makes it easier to choke!Quickly do “swallowing function test” to prevent aspiration pneumonia

Have a good chat and heal your healthy life

Visit an expert:

Tu Chuanzhou Medical Vice President of Department of Chest Medicine, Yuanrong Hospital

Image source: Yuanrong Hospital, 123RF