PULMONARY EDEMA SECONDARY TO CHRONIC RENAL FAILURE
(clue to CRF is dual lumen catheter Permcath used for hemodialysis)
(PermCath is a dual-lumen silicone catheter for permanent venous access for hemodialysis. Insertion of the PermCath is easy and, in case of malfunction, changing or removal of the catheter is easily accomplished. The PermCath is recommended as an alternative to existing techniques for intravenous access for hemodialysis. Permcath can be used as a temporary as well as a long-term vascular access for hemo dialysis. It combines the advantages of being able to be used immediately and for an indefinite period that varies from weeks to months).
CAUSES
Cardiogenic
- Congestive heart failure
- Severe heart attack with left ventricular failure
- Severe arrhythmias (tachycardia/fast heartbeat or bradycardia/slow heartbeat)
- Hypertensive crisis
- Pericardial effusion with tamponade
- Fluid overload, e.g., from kidney failure or intravenous therapy
Non-cardiogenic
This form is contiguous with ARDS (acute respiratory distress syndrome):
- Inhalation of toxic gases
- Multiple blood transfusions
- Severe infection
- Pulmonary contusion, i.e., high-energy trauma
- Multitrauma, e.g., severe car accident
- Neurogenic, e.g., subarachnoid hemorrhage
- Aspiration, e.g., gastric fluid or in case of drowning
- Certain types of medication
- Upper airway obstruction
- Arteriovenous malformation
- Reexpansion, i.e. post pneumonectomy or large volume thoracentesis
- Reperfusion injury, i.e. postpulmonary thromboendartectomy or lung transplantation
- Ascent to high altitude occasionally causes high altitude pulmonary edema(HAPE).
RADIOGRAPHIC APPEARANCES DUE TO DIFFERENT CAUSES.
1.Postobstructive pulmonary edema typically manifests radiologically as septal lines, peribronchial cuffing, and, in more severe cases, central alveolar edema.
2.Pulmonary edema with chronic pulmonary embolism manifests as sharply demarcated areas of increased ground-glass attenuation.
3.Pulmonary edema with veno-occlusive disease manifests as large pulmonary arteries, diffuse interstitial edema with numerous Kerley lines, peribronchial cuffing, and a dilated right ventricle.
4.Pulmonary edema following administration of cytokines demonstrates bilateral, symmetric interstitial edema with thickened septal lines.
5.High-altitude pulmonary edema usually manifests as central interstitial edema associated with peribronchial cuffing, ill-defined vessels, and patchy airspace consolidation.
6.Neurogenic pulmonary edema manifests as bilateral, rather homogeneous airspace consolidations that predominate at the apices in about50% of cases .
7.Reperfusion pulmonary edema usually demonstrates heterogeneous airspace consolidations that predominate in the areas distal to the recanalized vessels.
8.Postreduction pulmonary edema manifests as mild airspace consolidation involving the ipsilateral lung, whereas pulmonary edema due to air embolism initially demonstrates interstitial edema followed by bilateral, peripheral alveolar areas of increased opacity that predominate at the lung bases.