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Mechanisms of Pulmonary Edema

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Principles of Pulmonary Protection in Heart Surgery

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Abstract

Pulmonary edema is an abnormal collection of fluid in extravascular tissue or spaces of the lung.1 The lungs have a dynamic water content; water and proteins continuously move into the interstitial lung spaces and return to the circulation via the lymphatic system. It is generally accepted that fluid movement between these spaces is governed by Starling’s forces across semipermeable membranes. Pulmonary edema is the result of physiologic derangements that disrupt the normal circulation of fluids within the microstructure of the lung. This derangement can be an increase in pressures across the microvasculature (cardiogenic or highpressure edema), a loss of integrity of the pulmonary capillary (increased permeability edema), or a combination of both. Pulmonary edema is associated with a variety of processes, including cardiac dysfunction, sepsis, traumatic injuries, occupational exposures, organ transplantation, blood transfusion, metabolic derangements, and fluid resuscitation. Although the clinical presentations of pulmonary edema, which manifests as signs and symptoms of hypoxia, may be similar, the treatments and prognosis of different types of pulmonary edema are quite different. This chapter reviews the different mechanisms that cause pulmonary edema.

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Authors and Affiliations

  1. University of Miami, Jackson Memorial Hospital, Miami, FL, USA

    Si Pham

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  1. Si Pham
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  2. Eddie Manning
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Correspondence to Si Pham .

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Editors and Affiliations

  1. Federal University of Sao Paulo, Sao Paulo, 04023900, Brazil

    Edmo Atique Gabriel

  2. University of Miami, 1611 N.W. 12th Avenue, Miami, 33136, Florida, USA

    Tomas Salerno

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Pham, S., Manning, E. (2010). Mechanisms of Pulmonary Edema. In: Gabriel, E., Salerno, T. (eds) Principles of Pulmonary Protection in Heart Surgery. Springer, London. https://doi.org/10.1007/978-1-84996-308-4_16

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  • DOI: https://doi.org/10.1007/978-1-84996-308-4_16

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