Swelling of the lungs: symptoms and treatment
The disease, which is inherent in the formation of pulmonary insufficiency, represented as a mass release of the transudate from the capillaries into the pulmonary cavity and eventually contributes to the infiltration of the alveoli, is called pulmonary edema. In simple terms, the edema of the lungs is a situation where the fluid that has seeped through the blood vessels stagnates in the lungs. The disease is characterized as an independent symptom and can be formed on the basis of other serious ailments of the body.
The lungs are an organ consisting of alveoli, and they, in turn, are enveloped in a multitude of capillaries. It is in this organ that the gas exchange process takes place, due to which the human body is saturated with oxygen, thereby ensuring a normal working capacity. If the oxygen is not transferred to the alveolus, but the liquid, then this is the reason for the formation of pulmonary edema.
Pulmonary edema is a serious disease, which is characterized by terrible consequences in the form of death. The disease can affect both adults and children. Disease refers to a number of diseases that are characterized by the possibility of cure in the implementation of appropriate activities.
Classification of the disease
The pulmonary edema, depending on the cause of the onset, is divided into two types:
- Hydrostatic , which is inherent in the formation of the disease on the basis of increased intravascular hydrostatic pressure. With hydrostatic edema, the fluid is withdrawn from the vessel to the alveolus. Hydrostatic edema of the lungs often occurs due to cardiovascular deficiencies.
- Membrane , manifests itself on the basis of toxins, resulting in destruction of the walls of capillaries and alveoli. This gives a push to get the fluid into the intravascular space.
The pulmonary edema also has two forms of complications, which are associated with the corresponding symptoms and signs of ailment. These complications are called:
Of these two forms it is necessary to distinguish the first (alveolar), since it is the most dangerous and leads to terrible consequences, in particular, to the death of a person. Interstitial, in turn, is a more gentle form, which is subject to treatment and successful recovery. If you do not take appropriate medical measures, then this form is aggravated and turns into the alveolar.
Lung edema has another type of classification: the severity of manifestations. There are four degrees that have the following symptoms:
- The first degree — is called precancerous and is characterized by the appearance of weak signs of dyspnea and a disorder of the frequency and rhythm of breathing.
- The second degree — the average, which is inherent in the appearance of wheezing. Dyspnea increases.
- Third degree — the disease takes a severe character and is characterized by increased dyspnoea and wheezing, which can be heard even from a distance.
- Fourth degree — the immediate symptoms of the ailment arise: weakness, sweating, wheezing, etc. More about the symptoms in the symptomatic section of the disease.
Causes of occurrence
The causes of the formation of ailment in humans are very diverse, but they are worth knowing, since the consequences of lung ailment are serious and deadly. Often, pulmonary edema occurs due to complications of a number of different diseases. These reasons are due to the following factors:
- Acute intoxication of the body . It arises from the penetration into the body of toxic substances, both infectious and non-infectious. Toxic components negatively affect the alveolar membranes and cause the removal of fluid from the pulmonary interstitium. Intoxication of the body includes: bacterial pneumonia, excess drugs, poisoning with poison or narcotic drugs.
- Acute malaise of the left ventricle . As a result of this disease, pathological deviations of the cardiovascular system occur (myocardial infarction, heart disease, arterial hypertension, angina, etc.). On the basis of these diseases, pulmonary edema may form.
- Chronic pulmonary disease . These include: emphysema, bronchial asthma, pneumonia, malignant tumors in the lung cavity.
- With an aggravating physical load . So, for example, if an athlete overcomes another ascent to a mountain, then the appearance of a lung edema is not excluded. It is more common for women athletes, and less often for men.
- PE . As a result of blockage of the pulmonary artery by a substance in the form of a thrombus. This reason is due to the lightning-fast appearance of pulmonary edema, leading to the death of a person.
- With a decrease in oncotic pressure . As a consequence, there is a decrease in protein content in the blood, and such diseases are formed: liver cirrhosis, chronic hemorrhagic syndrome.
- With excessive use of drugs , especially when administered intravenously, if the excretory function of the kidneys is impaired
- Severe head injuries .
- With prolonged mechanical ventilation due to increased oxygen concentration
- In case of vomiting into the respiratory system . Most often this cause occurs in newborn babies with an incorrect position during sleep. As a result, such emetic discharges in the respiratory tract not only cause pulmonary edema, but also lead to the death of the child.
- When drowning or ingesting other substances in the respiratory tract .
The root cause of pulmonary edema is determined by the classification of the following two types:
- Not cardiogenic.
Causes of cardiogenic : the push to form the disease comes from left heart failure. Causes of insufficiency can be:
- Pathological abnormalities of the atrium;
- Ventricular pathology. These are: myocardial infarction, myocarditis, cardiosclerosis, heart disease, etc.
Causes of non-cardiogenic : is due to an overabundance of medications.
Based on the above reasons, a serious disease is formed — pulmonary edema, which has its symptoms of manifestation. Let’s talk about the symptoms in more detail.
Symptoms of the disease depend, first of all, on the stage of the disease and the rate of transition from the interstitial to the alveolar. This disease is also characterized by the types of timing of symptoms that are divided into:
- Sharp . Symptoms occur only four hours after the formation of the disease.
- Prolonged . Puffiness is gradual and after 2-3 days symptoms appear more clearly.
- Lightning fast . This kind of edema manifests itself quickly enough that it causes negative consequences for a person and his death. The lightning-like appearance does not have symptoms of mild illness, therefore, immediately after getting the exudate into the lungs, acute pains arise and, literally in a few hours, a fatal outcome. To death of the person lead also other kinds of an illness, but the most dangerous on terms is just lightning.
Consider the symptoms of pulmonary edema for interstitial and alveolar forms.
Symptoms of interstitial pulmonary edema
Symptoms of the interstitial form of the disease manifest themselves often at night, when a person is sleeping. On the eve of nothing bodes the appearance of such a disease, but this is only at first glance. Physical overexertion or insignificant psychoemotional disorder can give impetus to the development of symptoms of pulmonary edema. The first signs of pulmonary edema are manifested in the form of a slight cough, which is paid very little attention.
In this case, the symptoms grow closer to the morning, the patient becomes pale, he begins to have shortness of breath even at rest. When taking the position sitting and hanging his legs, shortness of breath decreases slightly. It is very difficult for a person to inhale on a full breast, there is an acute shortage of oxygen. Often, after the first symptoms of dyspnea, oxygen starvation is formed. When it occurs, dizziness and frequent headaches occur. The patient is characterized by a general malaise of the body.
Visually the appearance of the patient changes: the skin becomes pale, and when touched, a feeling of excessive sweating arises. Sweating or moisture of the skin is one of the important symptoms of pulmonary edema, which is also characterized by increased salivation and cyanosis of the nasolabial triangle.
In the lungs there are also changes: the type of breathing changes, it becomes more hoarse. Chryps are characterized by increased dryness during the course of the whole picture of the disease. There are also changes in the cardiovascular system:
- the first tone is weakened;
- the accent of the second tone is seen in the lungs
When conducting an X-ray examination, the following symptom picture opens up, which is characterized by the enlargement of the lung’s root system and the lack of structuredness. The doctor notices the vagueness of the picture of the lungs, as well as the presence of Curley lines in the segmental structure.
The interstitial form of the disease is characterized by a gradual increase in the disease and the possibility of curing. If the appropriate treatment is not carried out, the interstitial form is aggravated and the alveolar appearance already develops.
Symptoms of alveolar pulmonary edema
The alveolar phase arises both independently at the first signs of the disease, and is formed as a complication of the interstitial form. Symptoms of the alveolar form are characterized by intensity and suddenness, which affects negatively the human condition. The patient is experiencing a sharp increase in dyspnea, sometimes even suffocation. Increases the respiratory rate to 40 times per minute. Breathing is also characterized by noisy stibrous manifestations, and cough is increasing every time. It comes to the fact that with coughing, sputum is given off with foam and blood. Sputum production increases and in a short time reaches a value of 1.5-2 liters.
Along with these symptoms there is anxiety and psychoemotional arousal. The patient is not persevering on the spot, as is inherent in the form of an interstitial manifestation of the disease. There is a pallor of the skin, the tongue becomes white and diffuse cyanosis is noted. Reduced blood pressure, there is an increase in veins on the neck, there is a hyperhidrosis of the skin of the face and the whole body. And the separation of sweat is so intense that the clothing of the patient becomes wet.
When listening to heartbeat, its tone is not observed, which is directly related to noisy breathing. At X-ray examination the following picture is observed:
- changes in the shape and extent of the lungs
- darkening of both sides of the lungs in the basal area
Visual examination of the patient shows that his face becomes swollen. With the intensification of the disease, an active release of foam from the mouth begins, rattling becomes loud and bubbling.
Symptoms of pulmonary edema are characterized by complete malaise of the body, lack of desire to perform any work and inhibition. In a patient, headaches develop into migraine states, confusion arises. There is an ancestral state, which is often caused by confluence in a coma in the absence of appropriate measures. Alveolar appearance is characterized by an extremely difficult condition of the person, as a result of which a fatal outcome occurs. The factors leading the patient to death are oxygen starvation and asphyxia.
Symptoms of the disease in bedridden patients
The lightning-fast appearance of a disease is characterized, first of all, by the speed of the onset of symptoms. With this form, it is extremely rare to save a person, so often a diagnosis with a lightning-fast manifestation of pulmonary edema becomes the last in the patient’s book.
If the patient is in a recumbent position with symptoms of pulmonary edema, then the occurrence of relapse is enhanced. If in the vertical position the patient inhales a larger volume of oxygen, then in the horizontal opposite. This leads to the fact that the volume of the lung patient decreases, and, hence, the blood flow. At the same time, spontaneous discharge of sputum does not occur, in the horizontal position it accumulates in the lungs and causes the formation of an inflammatory process. On the basis of this symptomatic picture, pneumonia often appears.
In bedridden patients, the symptoms of the ailment increase gradually, with the first complaint being the increased rate of breathing. Then there is shortness of breath and insufficiency of air. There is an oxygen starvation, which, in turn, is caused by the following signs of manifestation:
Symptoms in bedridden patients are not clearly manifested, so there is no reason to diagnose it.
Knowing the main causes and symptoms of such a serious disease, it is worth turning to the issue of diagnosing ailment in a medical institution.
In addition to examining and questioning a patient who has been admitted with the first signs of pulmonary edema, an experienced physician must conduct a laboratory and instrumental examination to ensure the accuracy of the diagnosis.
Methods of laboratory and instrumental research include:
- Carrying out a blood gas examination . If there is an ailment, the study will show a moderate hypokanie, after which the PaCO 2 decreases with an increase in symptoms. At a later stage, this indicator will increase, and PaO 2 decrease. When measuring the CVP and the result in 12 cm of water. Art. And more will mean the presence of ailment.
- Biochemical blood test . With a reduced amount of protein, the picture becomes clearer.
- Electrocardiogram . If the result of this study shows signs of left ventricular hypertrophy, myocardial ischemia, etc., this indicates the presence of edema.
- Heart ultrasound . Ultrasound in the presence of an illness manifests itself in the form of visualization of hypokinesia zones of the myocardium. This is due to the fact that reduced contractility of the left ventricle.
- Chest x-ray . With the X-ray and the presence of signs of enlargement of the heart and lung roots, there is evidence of a predominance of factors for the presence of fluid in the lungs.
Based on these indicators, an experienced doctor determines not only the type of disease, but also a possible cause. It remains to go immediately to the appropriate methods of treatment, which are described below.
Treatment of pulmonary edema should be carried out immediately, since the disease is serious enough to harm the health and life of a person. First of all, you need to call an ambulance when the first symptoms appear. Compulsory treatment is performed after an exactly established diagnosis. The main method of treatment — intensive therapy, while the patient is always in the hospital under supervision. Treatment of pulmonary edema is not allowed on an outpatient basis under any circumstances.
At the first symptoms, and also during transportation to the patient’s hospital, the following measures should be taken:
- Place the patient in a semi-sitting position. The horizontal position for pulmonary edema is strictly prohibited .
- Upon the arrival of the ambulance: it is necessary for the patient to apply oxygen masks and also to carry out artificial ventilation of the lungs.
- It will be necessary to apply the harness to the upper part of the thighs, but you should control the pulse so that it does not disappear. The tourniquets are not tightened much, and necessarily not more than 20 minutes. They are shot not sharply, but with a gradual weakening. Why do I need a tourniquet? It is applied in order to reduce the flow of blood to the right atrium. This will not increase the pressure in a small circle of blood flow.
- Place nitroglycerin tablet under the tongue.
- If there are manifestations of acute pain, then Morphine 1% is administered.
- Use of diuretics, for example, Lasix.
After the patient is taken to therapy, the diagnosis and urgent adoption of appropriate measures are carried out. Based on the research, the doctor prescribes strict individual treatment under supervision.
With pulmonary edema, the following medications are used, which are taken by the patient in the fastest way — intravenously.
- Oxygen inhalation is used to eliminate the release of foam, while it must necessarily be combined with alcohol.
- With a decrease in blood pressure, drugs are used: Dopamine or Dobutamine, which increase the rhythm of cardiac contraction.
- Reducing symptoms of pain is done with Morphine.
- Nitroglycerin is administered intravenously in relation to saline.
- Diuretics are prescribed: Furosemide.
- If the disease is caused by a critically low heart rate, then the drug Atropine is used.
- Glucocorticosteroids. When spasms of the bronchi are applied Prednisolone.
- If the blood test showed a low protein content, then a fresh-frozen plasma infusion is used.
- If there are signs of the prevalence of infectious microorganisms, then a group of medicinal preparations from the antibiotic composition is appointed: Ciprofloxacin or Imipenem
In case of timely measures, treatment is successful and the patient is discharged after 2-3 weeks, depending on the form of the disease. The aforementioned drug treatment is common, so not all drugs will be prescribed. For each specific case, appropriate personal treatment is prescribed.
Prevention of such a serious disease can prevent its manifestation. If there are problems with heart failure, then the patient must prescribe a drug for the treatment of hypertension. In this case, a diet is prescribed, in which the main emphasis is on reducing the intake of salt and liquid. Also, fatty, smoked food is forbidden.
It is necessary to carry out the health measures of heart failure in a timely manner, not to overload the body with physical and respiratory loads. Conduct an examination of the body, so you can prevent not only the development of edema of the lungs, but also many other serious ailments.