Abstract
Pulmonary edema is defined as the abnormal accumulation of fluid in the pulmonary extravascular space. It is associated with disturbances of lung volumes, lung mechanics, and gas exchange. Pulmonary edema in the perioperative setting can result from multiple causes (Table 1). The incidence of all-cause perioperative pulmonary edema in contemporary anesthesia and critical care is not known. While pulmonary edema was listed among the 66 adverse outcome codes in the Multicenter Study of General Anesthesia [1], the incidence of this outcome was not reported in results [2]. The overall incidence of heart failure was 0.4% (70 of 17,201 patients), the vast majority of whom (91%) were ASA physical status 1 or 2 [1]. Preoperative myocardial ischemia was the sole significant predictor for heart failure [3].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Forrest JB, Rehder K, Goldsmith CH, et al (1990) Multicenter Study of General Anesthesia. I. Design and patient demography. Anesthesiology 72: 252–261
Forrest JB, Cahalan MK, Rehder K, et al (1990) Multicenter Study of General Anesthesia. II. Results. Anesthesiology 72: 262–268
Forrest JB, Rehder K, Cahalan MK, et al (1992) Multicenter Study of General Anesthesia. III. Results. Anesthesiology 76: 3–15
Arieff AI (1999) Fatal postoperative pulmonary edema: pathogenesis and literature review. Chest 115: 1371–1377
Braunwald E, Colucci WS, Grossman W (1997) Clinical aspects of heart failure: High output failure; pulmonary edema. In: Braunwald E (ed) Heart Disease 5th Ed. W. B. Saunders, Philadelphia, pp 445–470
Colucci WS, Braunwald E (1997) Pathophysiology of heart failure. In: Braunwald E (ed) Heart Disease 5th Ed. W. B. Saunders, Philadelphia, pp 394–420
Smith WS, Matthay MA (1997) Evidence for a hydrostatic mechanism in human neuro-genic pulmonary edema. Chest 111: 1326–1333
Bernard GR, Brigham KL (1986) Pulmonary edema. Pathophysiologic mechanisms and new approaches to therapy. Chest 89: 594–600
Staub NC (1981) Pulmonary edema due to increased microvascular permeability. Ann Rev Med 32: 291–312
Sprung CL, Long WM, Marcial EH, et al (1987) Distribution of proteins in pulmonary edema. The value of fractionated concentrations. Am Rev Resp Dis 136: 957–963
Goldman L, Caldera DL, Nussbaum SR, et al (1977) Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 297: 845–850
Goldman L, Caldera DL, Nussbaum SR, et al (1987) Multifactorial index of cardiac risk in noncardiac surgical procedures: ten-year status report. J Cardiothorac Anesth 1: 237244
Detsky AS, Abrams HB, McLaughlin JR, et al (1986) Predicting cardiac complications in patients undergoing noncardiac surgery. J Gen Intern Med 1: 211–219
Cooperman M, Pflug B, Martin EW Jr, Evans WE (1978) Cardiovascular risk factors in patients with peripheral vascular disease. Surgery 84: 505–509
Sprung J, Abdelmalak B, Gottlieb A, et al (2000) Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery. Anesthesiology 93: 129140
Morgan PW, Goodman LR (1991) Pulmonary edema and the adult respiratory distress syndrome. Radiol Clin North Am 29: 943–963
Neumann P (1999) Extravascular lung water and intrathoracic blood volume: double versus single indicator dilution technique. Intensive Care Med 25: 216–219
Schuller D, Mitchell JP, Calandrino FS, et al (1991) Fluid balance during pulmonary edema. Is fluid gain a marker or a cause of poor outcome? Chest 100: 1068–1075
Shires GT III, Peitzman AB, Albert SA, et al (1983) Response of extravascular lung water to intraoperative fluids. Ann Surg 197: 515–519
Wickerts CJ, Bloomqvist H, Berg B, et al (1991) Furosemide, when used in combination with positive end-expiratory pressure, facilitates the resorption of extravascular lung water in experimental hydrostatic pulmonary oedema. Acta Anaesth Scand 35: 776–783
Bjertnaes L.J, Koizumi T, Newman JH (1998) Inhaled nitric oxide reduces lung fluid fil- tration after endotoxin in awake sheep. Am J Respir Crit Care Med 158: 1416–1423
Dellinger RP, Zimmerman JL, Taylor RW, et al (1998) Effects of inhaled nitric oxide in patients with acute respiratory distress syndrome: results of a randomized phase II trial. Inhaled Nitric Oxide in ARDS Study Group. Crit Care Med 26: 15–23
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2001 Springer-Verlag Italia
About this paper
Cite this paper
Atlee, J.L., Segal, E. (2001). Diagnosis and Management of Pulmonary Edema in the Perioperative Period. In: Atlee, J.L., Vincent, JL. (eds) Critical Care Cardiology in the Perioperative Period. Topics in Anaesthesia and Critical Care. Springer, Milano. https://doi.org/10.1007/978-88-470-2955-2_15
Download citation
DOI: https://doi.org/10.1007/978-88-470-2955-2_15
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0133-6
Online ISBN: 978-88-470-2955-2
eBook Packages: Springer Book Archive