Cardiogenic pulmonary oedema: alarmingly poor long term prognosis. Analysis of risk factors

Marcinkiewicz, Marta; Ponikwicka, Katarzyna; Szpakowicz, Anna; Musiał, Włodzimierz J.; Kamiński, Karol

doi:10.5603/kp.2013.0158

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…Additionally, hyponatremia is an independent poor prognostic factor of heart failure [11][12][13][14][15][16]. However, severe hyponatremia with serum sodium levels below 130 mEq/dL rarely occurs, with a prevalence of 2-5% in patients with acute decompensated heart failure [17,18]. In our case, the serum sodium level at admission was 119 mEq/L, which is a relatively low value for heart failure.…”

Section: Discussionmentioning

confidence: 71%

A case of congestive heart failure caused by secondary hypocortisolism

Nagura

Kodera

Hayakawa

et al. 2017

Clinical Case Reports

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Section: Discussionmentioning

confidence: 71%

A case of congestive heart failure caused by secondary hypocortisolism

Nagura

Kodera

Hayakawa

et al. 2017

Clinical Case Reports

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“…Patients with hypertensive cardiogenic pulmonary edema represent approximately 25% of hospital admissions for patients with CCF, resulting in more than 250,000 annual hospital admissions and has a high mortality of between 15–20% [5,6]. Special attention should be paid to the diagnosis in the elderly population, given that the median age for acute pulmonary edema is 74 years [7]. Several comorbidities are associated with hypertensive cardiogenic pulmonary edema, the most common being hypertension and coronary artery disease resulting in ischemic heart disease and CCF (Figure 1) [8].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Hypertensive Cardiogenic Edema with Intravenous High-Dose Nitroglycerin in a Patient Presenting with Signs of Respiratory Failure: A Case Report and Review of the Literature

et al. 2019

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Patient: Male, 63Final Diagnosis: Hypertensive cardiovenic pulmonary edemaSymptoms: Shortness of breathMedication: —Clinical Procedure: —Specialty: General and Internal MedicineObjective:Management of emergency careBackground:Pulmonary edema is the accumulation of fluid in the lung secondary to increased hydrostatic pressure. Hypertensive cardiogenic pulmonary edema presents with a sudden onset of severe dyspnea, tachycardia, and tachypnea, and can occur when the systolic blood pressure exceeds 160 mmHg in association with acute decompensated congestive cardiac failure (CCF). A case is presented of hypertensive cardiogenic pulmonary edema treated with high-dose nitroglycerin and includes a review of the literature.Case Report:A 63-year-old Hispanic male with a medical history of hypertension, coronary artery disease, heart failure with a reduced ejection fraction of 35%, chronic kidney disease (CKD) and diabetes mellitus, presented as an emergency with acute, severe dyspnea. The patient was initially managed with 100% oxygen supplementation and intravenous (IV) high-dose nitroglycerin (30 mcg/min), which was titrated every 3 minutes, increasing by 15 mcg/min until a dose of 120 mcg/min was reached. After 18 minutes of aggressive therapy, the patient’s condition improved and he no longer required mechanical ventilation.Conclusions:Hypertensive cardiogenic pulmonary edema is a challenging clinical condition that should be diagnosed and managed as early as possible, and distinguished from respiratory failure due to other causes. Although hypertensive cardiogenic pulmonary edema is usually managed acutely with high-dose diuretics, this case has highlighted the benefit of high-dose IV nitroglycerin, and review of the literature supports this treatment approach.

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“…Specific conditions such as neurogenic pulmonary oedema, negative pressure pulmonary oedema, and pulmonary oedema associated with myocardial infarction, cardiogenic shock or cardiac arrest have been studied and are often linked with the development of APO. 8 , 9 , 10 , 11 However, even in such conditions, in the absence of a diagnostic gold standard, the diagnosis of pulmonary oedema typically rests on the presence of radiological features and results of clinical assessment. 12 , 13 …”

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confidence: 99%

Radiologically and clinically diagnosed acute pulmonary oedema in critically ill patients: prevalence, patient characteristics, treatments and outcomes

El-Khawas¹,

Richmond²,

Hessels³

et al. 2021

Critical Care and Resuscitation

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BACKGROUND: Acute pulmonary oedema is a life-threatening syndrome diagnosed based on radiological and clinical findings. However, to our knowledge, no studies have investigated this syndrome in critically ill patients. OJECTIVE: To describe the prevalence of radiologically and clinically diagnosed pulmonary oedema (RCDPO) in critically ill patients, characteristics of diagnosed patients, and treatments and outcomes in this patient population. METHODS: We conducted a retrospective study using natural language processing to identify all radiological reports of pulmonary oedema among patients who had been admitted to single tertiary intensive care unit (ICU) over a 1-year period (January 2015 to January 2016). We reviewed clinical data, discharge diagnosis, treatment and outcomes for such patients, and used multivariable logistic regression analysis to identify the association of RCDPO with various outcomes. RESULTS: Out of 2001 ICU patients, we identified 238 patients (11.9%) with RCDPO. Patients with RCDPO were more acutely ill, had more chronic liver disease and had more chronic renal failure than critically ill patients who did not have RCDPO. They were typically admitted with acute cardiovascular disease; were more likely to receive invasive mechanical ventilation and continuous renal replacement therapy; had longer duration of ICU and hospital stay; were more likely to die in hospital; and, if discharged alive, were more likely to be admitted to a chronic care facility. In total, 46 RCDPO patients (19.3%) died in hospital. On multivariable analysis, only age and continuous renal replacement therapy were independently associated with mortality. In contrast, invasive mechanical ventilation was associated with a 2.5 times greater odds of radiological resolution. CONCLUSION: RCDPO affected about one in eight ICU patients. Such patients were sicker and had more comorbidities. The presence of RCDPO was independently associated with higher risk of death. Invasive mechanical ventilation was the only intervention independently associated with greater odds of radiological resolution.

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Cardiogenic pulmonary oedema: alarmingly poor long term prognosis. Analysis of risk factors

Cited by 8 publications

References 13 publications

A case of congestive heart failure caused by secondary hypocortisolism

A case of congestive heart failure caused by secondary hypocortisolism

Treatment of Hypertensive Cardiogenic Edema with Intravenous High-Dose Nitroglycerin in a Patient Presenting with Signs of Respiratory Failure: A Case Report and Review of the Literature

Radiologically and clinically diagnosed acute pulmonary oedema in critically ill patients: prevalence, patient characteristics, treatments and outcomes

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