Neurogenic Pulmonary Edema
| Autor: | Vesna Šerić, Marina Roje-Bedeković, Vida Demarin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
Lung - physiopathology
Lung diseases - physiopathology Pulmonary edema - physiopathology Pulmonary edema - etiology Pulmonary edema - diagnosis Brain diseases - complications Pluća - fiziopatologija Plućne bolesti - fiziopatologija Plućni edem - fiziopatologija Plućni edem - etiologija Plućni edem - dijagnostika Bolesti mozga - komplikacije |
| Zdroj: | Acta clinica Croatica Volume 43 Issue 4 |
| ISSN: | 1333-9451 0353-9466 |
| Popis: | The association of pulmonary edema with central nervous system disease without underlying cardiopulmonary disease is known as neurogenic pulmonary edema (NPE). The most common precipitants of NPE are epileptic seizures, head injury, and subarachnoid or intracerebral hemorrhage. Since the most common neurologic events are associated with increased intracranial pressure, intracranial hypertension is considered to be a key etiologic factor. Various theories regarding the pathogenesis of NPE have been focused on the potential roles for the hypothalamus, the medulla, elevated intracranial pressure, and activation of the sympathoadrenal system. A distinctive form of myocardial injury, contraction band necrosis, is the likely pathologic substrate of cardiac injury. NPE characteristically presents within minutes to hours of a severe central nervous system insult. Resolution of NPE usually occurs within several days. Dyspnea is the most common NPE associated symptom, and mild hemoptysis is also present in many patients. Definitive diagnosis of NPE is difficult because of the nonspecific nature of the clinical signs and routine diagnostic tests. The outcome of patients with NPE is usually determined by the course of the neurologic insult that has produced NPE, and specific treatment should focus on the underlying disorder. NPE is generally managed in a supportive and conservative fashion because many cases of NPE are well tolerated and the majority of them resolve within 48 to 72 hours. Neurogeni plućni edem je rijedak oblik plućnog edema obilježen povišenjem plućne intersticijske i alveolarne tekućine, a razvija se unutar nekoliko sati od nastanka dobro definiranog neurološkog oštećenja. Najčešći uzroci neurogenog plućnog edema su epileptični napadaji, ozljede glave i subarahnoidna ili intracerebralna krvarenja. Kako su najčešći neurološki poremećaji povezani s povišenim intrakranijskim tlakom, smatra se da je povišeni intrakranijski tlak ključni čimbenik u nastanku neurogenog plućnog edema. Različite teorije o patogenezi neurogenog plućnog edema smatraju da u njegovom nastanku moguću ulogu imaju hipotalamus, medula oblongata, povišen intrakranijski tlak i aktiviranje simpatoadrenergičnog sustava. Neurogeni plućni edem znakovito nastupa unutar nekoliko minuta do sati od nastanka teškog oštećenja središnjeg živčanog sustava. Najčešće se očituje naglim nastankom dispneje, a ponekad se javlja i blaga hemoptiza. Zbog njihove nespecifičnosti laboratorijske pretrage ne pomažu u donošenju dijagnoze neurogenog plućnog edema. Ishod u bolesnika s neurogenim plućnim edemom obično određuje tijek osnovne neurološke bolesti koja je i dovela do tog stanja, pa specifično liječenje treba usmjeriti na liječenje osnovne bolesti. Neurogeni plućni edem se općenito zbrinjava konzervativnom potpornom terapijom, jer bolesnici u većini slučajeva ovo stanje podnose relativno dobro i u većini slučajeva simptomi prestaju unutar 48-72 sata. |
| Databáze: | OpenAIRE |
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