Drowning: Another Plunge

Putman, Charles E.; Tummillo, Anna M.; Myerson, Daniel A.; Myerson, Paul J.

doi:10.2214/ajr.125.3.543

Cited by 23 publications

(5 citation statements)

References 8 publications

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“…90% of patients, the laryngospasm relaxes secondary to hypoxia and large amounts of water are aspirated (35). In such cases, the lung lesions are no longer associated with pressure edema but mainly with hypoxia, which leads to cytokine release and subsequent permeability edema (36)(37)(38). In addition to causing hypoxia, inhaled water has a deleterious effect on the capillary endothelium, alveolar pneumocytes, and surfactant production.…”

Section: Near Drowning Pulmonary Edemamentioning

confidence: 99%

“…Stage 2 and 3 lesions are radiologically nonspecific, varying from tiny, ill-defined lesions to large, lobar airspace consolidations. Lesion size depends on the volume of inhaled water, the duration of the ensuing hypoxia, and on whether fresh or salt water is involved (35,37,38). Clearing of the lungs begins slowly and continues at a rate that depends on the severity of capillary and alveolar damage.…”

Section: Near Drowning Pulmonary Edemamentioning

confidence: 99%

“…Clearing of the lungs begins slowly and continues at a rate that depends on the severity of capillary and alveolar damage. This process occurs several days after the incident if the situation remains uncomplicated by gastric aspiration, infection, or other causes of additional alveolar damage (37,38). c. Figure 13.…”

Section: Near Drowning Pulmonary Edemamentioning

confidence: 99%

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Clinical and Radiologic Features of Pulmonary Edema

Gluecker¹,

Capasso²,

Schnyder³

et al. 1999

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Pulmonary edema may be classified as increased hydrostatic pressure edema, permeability edema with diffuse alveolar damage (DAD), permeability edema without DAD, or mixed edema. Pulmonary edema has variable manifestations. Postobstructive pulmonary edema typically manifests radiologically as septal lines, peribronchial cuffing, and, in more severe cases, central alveolar edema. Pulmonary edema with chronic pulmonary embolism manifests as sharply demarcated areas of increased ground-glass attenuation. Pulmonary edema with veno-occlusive disease manifests as large pulmonary arteries, diffuse interstitial edema with numerous Kerley lines, peribronchial cuffing, and a dilated right ventricle. Stage 1 near drowning pulmonary edema manifests as Kerley lines, peribronchial cuffing, and patchy, perihilar alveolar areas of airspace consolidation; stage 2 and 3 lesions are radiologically nonspecific. Pulmonary edema following administration of cytokines demonstrates bilateral, symmetric interstitial edema with thickened septal lines. High-altitude pulmonary edema usually manifests as central interstitial edema associated with peribronchial cuffing, ill-defined vessels, and patchy airspace consolidation. Neurogenic pulmonary edema manifests as bilateral, rather homogeneous airspace consolidations that predominate at the apices in about 50% of cases. Reperfusion pulmonary edema usually demonstrates heterogeneous airspace consolidations that predominate in the areas distal to the recanalized vessels. Postreduction pulmonary edema manifests as mild airspace consolidation involving the ipsilateral lung, whereas pulmonary edema due to air embolism initially demonstrates interstitial edema followed by bilateral, peripheral alveolar areas of increased opacity that predominate at the lung bases. Familiarity with the spectrum of radiologic findings in pulmonary edema from various causes will often help narrow the differential diagnosis.Abbreviations: ARDS = adult respiratory distress syndrome, DAD = diffuse alveolar damage and the Institute of Diagnostic Radiology, Inselspital, Bern, Switzerland (P.V.). Recipient of a Certificate of Merit award for a scientific exhibit at the 1998 RSNA scientific assembly.

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Section: Near Drowning Pulmonary Edemamentioning

confidence: 99%

Section: Near Drowning Pulmonary Edemamentioning

confidence: 99%

See 1 more Smart Citation

Clinical and Radiologic Features of Pulmonary Edema

Gluecker¹,

Capasso²,

Schnyder³

et al. 1999

RadioGraphics

287

139

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“…Kerley's lines, peribronchial cuffing, and patchy perihilar alveolar areas of airspace consolidation are seen [16]. With appropriate therapy, these features disappear completely within 24-48 h. However, in 90% of patients, the continued hypoxia leads to cytokine release and subsequent permeability edema [16][17][18]. Inhaled water also has a deleterious effect on the capillary endothelium, alveolar pneumocytes, and surfactant production.…”

Section: Pulmonary Edema (Pe)mentioning

confidence: 99%

“…11.3). The volume of inhaled water, duration of the continuing hypoxia, and the nature of inhaled water (fresh versus salt water) determine the lesion size [16,18].…”

Section: Pulmonary Edema (Pe)mentioning

confidence: 99%