Pulmonary oedema is accumulation of fluid in the alveoli due to an increase in pulmonary capillary venous pressure resulting from acute left ventricular failure.
This is an acute emergency.
- Frothy blood-tinged sputum
- Respiratory distress
Chest x-ray: Loss of distinct vascular margins, Kerley B lines, diffuse haziness of lung fields.
- Initiate treatment urgently and admit.
- Prop up patient in bed.
- Administer needed drugs:
- IV morphine 0.1–0.2mg/kg STAT may be repeated (watch for respiratory depression).
- IV frusemide 0.5–2mg/kg/dose, maximum 6mg/kg/dose. Infusion – 0.05mg/ kg/hour.
- Digitalize if not already on digoxin.
- IV aminophylline 6mg/kg over 15 min then 0.9mg/kg/hour.
- Give oxygen by nasal prongs or catheter.
- Start on oral medication as soon as possible.
- When the patient has stabilized, investigate to identify the cause.
- Manage the underlying cause.
- Refer to specialist:
- If patient fails to respond to above therapy.
- For definitive treatment of underlying cause