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Flash pulmonary edema is a clinical syndrome that begins suddenly and accelerates rapidly. Essentially all patients will present to the emergency department by ambulance. The initiating acute event often a vascular event such as intense vasoconstriction and not a cardiac event such as myocardial infarction.
It is often impossible to distinguish TRALI from acute respiratory distress syndrome (ARDS). The typical presentation of TRALI is the sudden development of shortness of breath, severe hypoxemia (O 2 saturation <90% in room air), low blood pressure, and fever that develop within 6 hours after transfusion and usually resolve with supportive care within 48 to 96 hours.
Negative-pressure pulmonary edema (NPPE), also known as Postobstructive Pulmonary Edema, is a clinical phenomenon that results from the generation of large negative pressures in the airways during attempted inspiration against some form of obstruction of the upper airways.
A chest x-ray showing pulmonary edema with bilateral pleural effusions. Along with: Elevations in brain-natriuretic peptide (BNP) or N-terminal (NT)-pro BNP. Evidence of cardiovascular system changes (tachycardia, hypertension, widened pulse pressure, jugular venous distension, peripheral edema) Evidence of fluid overload.
In 1994, a new definition was recommended by the American-European Consensus Conference Committee [6] [10] which recognized the variability in severity of pulmonary injury. [51] The definition required the following criteria to be met: acute onset, persistent dyspnea; bilateral infiltrates on chest radiograph consistent with pulmonary edema
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Intravascular fluid overload leads to polyuria and can cause flash pulmonary edema and cardiac arrest, with possibly fatal consequences. [4] [5] Death from SCLS typically occurs during this recruitment phase because of pulmonary edema arising from excessive intravenous fluid administration during the earlier leak phase.
Opioids have traditionally been used in the treatment of the acute pulmonary edema that results from acute decompensated heart failure. A 2006 review, however, found little evidence to support this practice. [17] The National Institutes for Health and Care Excellence (NICE) guidelines do not recommend routinely offering opioids in acute heart ...