Our patients followed up with a diagnosis of neurogenic pulmonary edema

Abstract

Neurogenic pulmonary edema is a clinical situation which developes as a result of central nervous system injury. It is rare in the childhood. Neurogenic pulmonary edema is a clinical diagnosis. Although the pathogenesis is not elucidated well, there is increase in pulmonary interstitial and alveolar fluid. The main principle in treatment of neurogenic pulmonary edema is supportive treatment and decreasing intracranial pressure as in acute respiratory distress syndrome. In this article, clinical properties of our two patients diagnosed with neurogenic pulmonary edema developed as a result of central nervous system injury are presented. (Turk Pediatri Ars 2015; 50: 241-4)

A Rare Case of Neurogenic Pulmonary Edema Following High-voltage Electrical Injury

“…These changes are followed by the constriction of the pulmonary veins which lead to increase in pulmonary capillary hydrostatic pressure and later leading to damage of alveolar wall and leakage of fluid into the interstitium and intra-alveolar space along with hemorrhage resulting in the typical picture of neurogenic pulmonary edema. 12–14 while Smith et al observed that in 7 out of 12 cases it is the increased pulmonary hydrostatic pressure which causes neurogenic pulmonary edema and not the increased lung capillary permeability. 15…”

Distant Organ Damage in Acute Brain Injury

“…Neurogenic pulmonary oedema (NPE) is a form of respiratory distress that timewise correlates with an onset of acute brain injury and cannot be explained by either heart failure or fluid overload [101]. NPE can occur in several conditions, such as: subarachnoid haemorrhage (SAH), intracerebral haemorrhage, trauma brain injury (TBI), status epilepticus, subdural hematoma, epidural hematoma and other CNS acute states [102][103][104][105][106][107][108][109][110] All of the abovementioned diseases, despite different aetiologies, share some of the key elements for the development of NPE. Brain injuries that cause NPE are often expressed as an acute increase in the intracranial pressure (ICP), followed by decreased cerebral perfusion or a direct damage of brainstem and hypothalamus [111].…”

“…Neurogenic pulmonary oedema (NPE) is a form of respiratory distress that timewise correlates with an onset of acute brain injury and cannot be explained by either heart failure or fluid overload [ 101 ]. NPE can occur in several conditions, such as: subarachnoid haemorrhage (SAH), intracerebral haemorrhage, trauma brain injury (TBI), status epilepticus, subdural hematoma, epidural hematoma and other CNS acute states [ 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 ]…”

Neurological Perspectives of Neurogenic Pulmonary Edema

“…These include enterovirus (EV)-71-induced brainstem encephalitis [20], subarachnoid bleeding (SAB) [21], intracerebral bleeding (ICB) [22], traumatic brain injury (TBI) [23], ischemic stroke [24], epilepsy [25], subdural hematoma [26], epidural hematoma [27], cerebral or spinal surgery [28], ce- rebral mass lesion [29], or other rarer causes (Table 1). According to a study of 36 patients with SAB-triggered NPE, predictors for the occurrence of NPE in patients with SAB were World Federation of Neurological Surgeons class, total power, and normalized low-frequency component [30].…”