Diagnosis and Management of Pulmonary Edema in the Perioperative Period

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].