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Acute Pulmonary Oedema

This is where there's excess fluid build-up in the lungs. It's most common cause is LV failure where the LV is unable to adequately pump blood into circulation, therefore creating congestion in the pulmonary system. This increased pressure pushes fluid out of the vessels and into the alveoli.

"Pulmonary Oedema" © Laboratoires Servier (Licensed under CC BY-SA 3.0）https://creativecommons.org/licenses/by/3.0/

The main complications here are Pulmonary HTN, and Pleural effusion.


It presents with:

  • Extreme dyspnoea

  • Restlessness

  • Anxiety

  • Cough +/- pink frothy sputum


O/E - Bilateral basal crackles, 3rd heart sound


Investigations to do:

  • Bloods - BNP, U&Es, Troponin

  • CXR

  • ECG

  • ABG


Management - IVF SOD:

  • Stop IVF

  • Sit up - fluid falls to lung bases, allowing the upper lungs to work effectively

  • Oxygen - be cautious with COPD patients

  • Diuretics - IV Furosemide 40mg to reduce overload on heart, making it pump more effectively



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