Email swelling - emergency care. Emergency assistance in the edema of light edema of the lungs first aid

The date: 01.07.2020

The edema of the lungs is the condition of the body, which develops with excessive accumulation of fluid in the out-of-rise spaces of the pulmonary fabric. The cause of the development of such a state can be as diseases of the heart (then the edema is called cardiogenic) and the pathology of other systems of the body, the reception of some medicinal substances (negrotogenic). But regardless of the causes of the occurrence, the edema of the lungs is a life-threatening state to eliminate which the first aid should be rendered immediately.

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Causes of occurrence

The development of pulmonary edema can be classified for the following reasons:

cardiogenic edema (develops with heart or vessel pathology);
due to parenteral infusion of a large volume of liquids;
inflammatory (with damage to light microorganisms);
caused by the endogenous effects of toxic substances (with hepatic or renal failure) and exogenous lesions of the respiratory tract (the ingestion of the vapors of poisonous and toxic chemical compounds);
allergic.

Development mechanism

There are several mechanisms for the emergence and development of pulmonary edema.

Cardiogenic

Cardiogenic pulmonary swelling can manifest itself in heart failure. It occurs in the pathology of the left heart departments - the weakening of the systolic function of the left ventricle, which develops with myocardial infarction, myocardium, cardiosclerosis, hypertension, stenosis of a mitral valve and aortic valve. In the development of heart failure, the role of the left atrium arising in mitral stenosis can play. With such pathological conditions, the pressure in the ventricular cavity of the heart and the left atrium, which turns out to be overcrowded blood is increasing. Then there is an increase in blood pressure first in the pulmonary veins, then in capillaries and arteries of a small circle of blood circulation. The vessels in the lungs are expanding, their permeability and plasma increases, begins to leave the vascular bed. Finding into the alveoli, the liquid disrupts the diffusion of the gas mixture through the alveolar membrane into the bloodstream. Against this background, the oxygen content in the blood decreases, the oxygen perfusion of the heart tissues sharply deteriorates, which can even lead to its stop.

Caused by parenteral infusion liquids

Elevation of the lungs may appear with an excessively fast infusion of a large volume of any fluid (isotonic solution of sodium chloride, medicinal substances, blood preparations). Edema is developing as a result of a decrease in oncotic (due to a decrease in protein concentration) and an increase in the hydrostatic pressure of blood (due to the increase in the volume of fluid circulating over vessels).

Inflammatory

In case of bacterial, fungal or viral lesions of lightweight swelling, due to the attack of the alveolar-capillary membrane by microbial agents. In this case, its permeability increases, which contributes to the development of edema inside the alveoli and a decrease in the diffusion of oxygen. The toxins of the outer environment also increase the permeability of the membranes between alveoli and capillaries.

Allergic

Allergic pulmonary edema is carried out by a sharp increase in capillary permeability as a result of the action of allergic reaction mediators (histamine, serotonin) released from labrocytes. There are two stages of pulmonary edema, which replace each other during the progression of pathology: interstitial - liquid part of the blood overcomes the histohematic barrier, hesitates from blood vessels in the stroma of the lung; Parenchimato - plasma passes into the cavity of the alveoli, overcoming the estate-bearing barrier.

Symptoms

Symptoms of pulmonary edema depend on the development phase of pathology.

At an interstitial stage, it is noted:

dyspnea;
weakness;
dizziness;
tachycardia;
cough;
breathing with wheezami;
the pallor of the skin and mucous membranes.

Parenchimatous - to the symptoms of interstitial joined:

cough with the experience of a large number of foam wet pink color;
strengthening shortness of breath in the lying position;
bubble breathing.

First aid

Under the edema of the lungs, the oxygen transport and carbon dioxide can be slowed down through the membranes of pulmonary alveoli. The consequence of the impaired gas exchange is hypoxia - a reduced oxygen content in the body tissues. Therefore, first aid should be aimed at eliminating the resulting pathological condition.

First aid for the edema of the lungs is the necessary event to maintain human life.

First aid is a set of events that are aimed at eliminating sharp symptoms and providing life support.

If there is a pulmonary edema, then the first aid is to call ambulance, since all necessary medicines and devices are rarely rarely available. While waiting for qualified doctors, people surrounding the patient must take the necessary measures.

Email swelling: clinic and emergency care

Email swelling is such a state when too much liquid accumulates in the lungs. This is due to the large difference in colloid-osmotic and hydrostatic pressure in the lung capillaries.

There are two types of edema of the lungs:

Membranogenic - It occurs if the permeability of the capillaries increased dramatically. This type of edema of the lungs often occurs as a supporter of other syndromes.

Hydrostatic - develops due to diseases in which the hydrostatic capillary pressure increases sharply, and the liquid part of the blood finds the output in such a quantity in which it cannot be derived through lymphatic pathways.

Clinical manifestations

Patients at the edema of the lungs complain about the lack of air, have a frequent breath and sometimes attacks of cardiac asthma arising during sleep.

Skin covers are pale, and from the side of the nervous system there may be inadequate reactions in the form of a confusion of consciousness or its oppression.

With the edema of the lungs, the patient is cold sweat, and when listening to lungs, wet wheezes are found in the lungs.

First aid

At this time it is very important to act quickly and accurately, because in the lack of support, the situation can deteriorate sharply.

When ambulance arrives, all the actions of specialists will be directed for three purposes:

reduce the excitability of the respiratory center;
remove the load of a small circle of blood circulation;
remove foaming.

In order to reduce the excitability of the respiratory center, the patient is injected with morphine, which remove not only the swelling of the lungs, but also an asthma attack. This substance is unsafe, but here it is the necessary measure - morphine selectively affects brain centers responsible for breathing. Also, this medication makes the influx of blood to the heart not so intense and thanks to this stagnation in the pulmonary fabric decreases. The patient becomes much calmer.

This substance is introduced either intravenously or subcutaneously, and after 10 minutes its effect occurs. If the pressure is lowered, pridol is introduced instead of morphine, which has a less pronounced, but similar effect.

Strong diuretics are also used to remove pressure (for example, furosemide).

To unload the circle of small blood circulation, resort to a dropper with nitroglycerin.

If there are symptoms of disturbance, the patient give a weak neuroleptic.

Together with these methods, oxygen therapy is shown.

If a patient has a resistant foam, this treatment will not give the necessary effect, as it can block the respiratory tract. To avoid this, doctors give inhalation with 70% ethyl alcohol, which is passed through oxygen. Then the specialists suck over the catheter an extra liquid.

Causes of lung edema

Hydrostatic edema may occur due to:

Heart dysfunction.
Ingressing air vessels, thromboms, fat.
Bronchial asthma.
Lung tumors.

The pulmonary membrane swelling may occur for the following reasons:

Renal failure.
Chest injury.
Getting toxic vapors, gases, smoke, mercury vapor, etc.
Throwing the gastric content in the respiratory tract or water.

Emergency assistance in pulmonary edema

Elevation (Cardiac Asthma) - syndrome, developing due to a sharp increase in hydrostatic pressure in the pulmonary artery (hearty genesis, arrhythmia, hypertensive crisis, venous stagnation, central, altitude disease, volumetric overload by colloids or crystalloids) or permeability (intoxication including oxygen, aspiration pneumonia fat embolism Sepsis, burn shock, injury, drowning) with fluid progestion in interstics (cardiac asthma) or alveoli (pulmonary edema).

Symptoms: A feeling of air shortness, suffocation of heartbeat inspiratory shortness of breath, dry cough, tachypnee, orthopneus, gray-pale cold sweat, acricyanosis, tachycardia rhythm gallop, hard breathing, are possible dry wheels. With the development of pulmonary edema: sharply pronounced suffocation; cough with the release of frothy pink sputum; At first in the upper departments, and then over the entire surface, creating solid-caliber moving wet wheels in combination with dry; Breathing gradually becomes bubble, Chen-Stokes breathing may appear; Cianoz face; Nabult cervical veins. On the ECG, changes are characteristic of the underlying disease and inversion of g, depression of ST.

Complications: sympathy referee failure, hypertensive crisis, arrhythmia.

Urgent Care. Support index (systolic pressure x CSS) / 100 in the range of 72-96 with systolic pressure is not lower than 100 mm RGT. Art. Sublime position of the upper half of the body; In the absence of diuretics - turnstiles on the lower limbs (the pulse on the arteries should be saved); Aspiration of foam; The defoamers (antiphesilak pairs of ethyl alcohol using the KI-ZM apparatus using the Gorsky apparatus, alcohol can be administered to / in or endorone - 2 ml of 33% solution, 96% alcohol - 1 ml per 3 ml of saline solution, slowly); Oxygen - 5-6 l / min, inhalations are intermitted every 30-40 min inhalation of 10-15 minutes of pure oxygen, with the loss of consciousness or ineffectiveness of therapy and VL with preservation of positive pressure by the end of the exhalation.

With diabetes\u003e 100 mm RG. A: V / in 96-200 μg / min nitroglycerin - up to 500 μg / min (use large concentrations, doses<100 мкг/мин снижают преднагрузку, при >200 μg / min Reduce and post-loading), starting dose 10-20 μg / min, in the urgent case with diastolic pressure\u003e 100 mm RT. Art. - 50 μg in / in inkino with the transition to infusion, if it is impossible to / in administration - sublingual, starting from the first dose of 2.5 mg, then 05-1 mg every 5 minutes. With diabetes\u003e 160 mm Hg. Art. (diastolic pressure\u003e 130 mm. mg / AMP).

After vasodilators in / in insertion, 05-1 mg / kg of furosemide in 1-2 min (20 mg / AMP, the initial dose of 05 mg / kg, in the absence of effect, repeat after 20 minutes, the total dose of 2 mg / kg).

With low CD<100 мм рт. ст. - 2-20 мкг/кг/мин допамина, при СД>100 mm RG. Art. and normal diastolic pressure - 2-20 μg / kg / min of dobutamine in the absence of an effect from the administration of vasodilators and inotropic drugs - in / in inkido 0.75 mg / kg of amrring (50-100 mg / AMP) for 2-3 minutes, Then 2-20 μg / kg / min.

It is possible to introduce morphine - 2-5 mg (10 mg / AMP) to / every 5-30 minutes to achieve the effect with careful control, it is necessary to ensure the possibility of intubating trachea.

With heart defects: morphine up to 10 mg,% furosemide up to 2 mg / kg. Additionally, with deficiency of the mitral valve: 0.25-05 mg of digoxin, nitroglycerin in the starting dose of 10-20 μg / min or up to 50 mg of pentamine in / c. With the stenosis of the mitral valve: nitroglycerin in the starting dose of 10-20 μg / min; If the swelling clinic persists with the fibrillation or fluttering of the atria - in / at 0.25-05 mg of digoxin, and in their absence - 0.25 mg of stanfantine. Aortic stenosis and insufficiency: glycosides, in the absence of effect - nitroglycerin. It is possible to be extremely cautious administration of dobutamine 2-20 μg / kg / min (except for mitral stenosis) or amrinone (in the absence of effect or intoxication by glycosides) 0.75 mg / kg in 2-3 minutes, then 2-20 μg / kg / min. With the introduction of CSS vasodilators, it should not exceed the initial 10%. The introduction of glycosides depends on whether the edema of glycosidic intoxication is triggered or the situation requires additional use of the drug (not used with nausea, vomiting, atrial flickering with AV-blockade, frequent ventricular extrasystole or ventricular tachycardia, a trough-shaped segment of the S7 segment).

With pneumonia: glycosides, prednicular up to 2 mg / kg, furosemide up to 2 mg / kg. In severe cases, a pentamine or sodium nitroprusside can be used at bronchial asthma in conventional dosages.

Treatment of arrhythmia - Only an Eit. If the central venous pressure is below 5 cm water. ST. "The large volumes of crystalloids are introduced.

Hospitalization. Urgent in the block of intensive therapy, bypassing the receiving office, after stabilizing the state or the relief of edema with constant ECG and auscultative monitoring, ensuring the inhalation of oxygen and / in drug administration. Transportability criteria (on a stretcher with a raised head end): The number of breathing is 22-26 per minute, the disappearance of foaming sputum and wet wheezing on the front surface of the lungs, a decrease in cyanosis, the translation of the patient in a horizontal position does not cause a new stabbing, hemodynamic stabilization. With first cardiac asthma, patients are hospitalized regardless of the results of treatment.

Easy swelling - emergency care, the main symptoms and methods of treating the disease.

Emails of light photos Email swelling - emergency care at the first symptoms of this disease. A similar severe condition occurs if liquid accumulates in the lungs in the lungs. The impaired blood circulation, insufficient enrichment of the lungs and alveoli oxygen can also provoke pathogenesis and pulmonary edema in progressive forms. In addition, all this can lead to the complication of the general condition of the body and end the death of the patient.

Therapy helps to eliminate pulmonary edema. Emergency help: First aid algorithm.

Be sure to provide a person when attacking the edema of the lungs, a sedentary or a sudden position.

It is necessary to suck from the respiratory tract of the patient the existing liquid.

If pressure rises, then it is necessary to perform bloodletting. Children should produce up to two hundred milliliters of blood, adults - up to three hundred milliliters.

The imposition of the harnesses in the edema of the lung should be carried out on the feet (about thirty - sixty minutes).

With alcohol vapors, inhalation is carried out. For children, it is used thirty percent alcohol, and for adults - seventy percentage.

It is necessary to introduce two millilita of twenty percent camphor solution to subcutaneously.

The respiratory tract should be enriched with oxygen, for this is used oxygen pillow.

What drugs are used in pulmonary edema?

Most effective fighting means are defoamers at the edema of the lungs. (that is, anti-inflation drugs). These substances increase the surface tension of the fluid, and also eliminate foaming. The most famous anti-inflating drug is simple ethyl alcohol. In the case of edema of the lungs, the patient needs to be raised with oxygen or air skipped through alcohol (from 30 to 90 percent). If, after that, the required effect will be achieved, it is necessary to use a more effective anti-antifomsilane, which is a silicone compound (its solutions are used in the inhalation method).

In addition, the edema of the lungs are effective are the means that reduce the hydration of pulmonary tissues, that is, dehydrating drugs. Here can be attributed to the manit and urea. They are introduced intravenously, while the blood osmotic pressure increases, the water moves from the echo tissues into the vessels row. Mantite and urea solutions are used at pulmonary edema and edema of other tissues (mainly brain). Urea, in particular, manitis, have good diuretic activity. They contribute to the removal of fluid from the body, and the tissue hydration is reduced with their help. With a similar purpose in the case of edema of the lungs, such ammonic, active drugs, such as a stacriman acid and furosemide are prescribed.

The therapeutic effect in the edema of the lungs allow to achieve hypotensive drugs. They reduce venous and blood pressure, and also reduce the filling of pulmonary tissue with blood, as a result of which the blood plasma moves into the lumen Alveol. It is advisable for a given disease, hypotensive, active, high-speed drugs, such as hygros, or benzohexoniums, which relate to the ganglipal groups. If the swelling of the lungs is caused by heart failure, then good effects allow to achieve heart glycosides like Corglikon, Stroofantin, and so on. Also, glucocorticoids are provided with high efficiency, which are administered intravenously (as, for example, prednisone).

First aid for the edema of the lungs is the necessary event to maintain human life.

First aid is a set of events that are aimed at eliminating sharp symptoms and providing life support.

Email swelling: clinic and emergency care

Email swelling is such a state when too much liquid accumulates in the lungs. This is due to the large difference in colloid-osmotic and hydrostatic pressure in the lung capillaries.

There are two types of edema of the lungs:

Membranogenic - It occurs if the permeability of the capillaries increased dramatically. This type of edema of the lungs often occurs as a supporter of other syndromes.

Clinical manifestations

Patients at the edema of the lungs complain about the lack of air, have a frequent breath and sometimes attacks of cardiac asthma arising during sleep.

Skin covers are pale, and from the side of the nervous system there may be inadequate reactions in the form of a confusion of consciousness or its oppression.

With the edema of the lungs, the patient is cold sweat, and when listening to lungs, wet wheezes are found in the lungs.

First aid

At this time it is very important to act quickly and accurately, because in the lack of support, the situation can deteriorate sharply.

When ambulance arrives, all the actions of specialists will be directed for three purposes:

reduce the excitability of the respiratory center;
remove the load of a small circle of blood circulation;
remove foaming.

Strong diuretics are also used to remove pressure (for example, furosemide).

To unload the circle of small blood circulation, resort to a dropper with nitroglycerin.

If there are symptoms of disturbance, the patient give a weak neuroleptic.

Together with these methods, oxygen therapy is shown.

Causes of lung edema

Hydrostatic edema may occur due to:

Heart dysfunction.
Ingressing air vessels, thromboms, fat.
Bronchial asthma.
Lung tumors.

The pulmonary membrane swelling may occur for the following reasons:

Renal failure.
Chest injury.
Getting toxic vapors, gases, smoke, mercury vapor, etc.
Throwing the gastric content in the respiratory tract or water.

Emergency assistance in pulmonary edema

and the development of pulmonary edema: sharply pronounced suffocation; cough with the release of frothy pink sputum; At first in the upper departments, and then over the entire surface, creating solid-caliber moving wet wheels in combination with dry; Breathing gradually becomes bubble, Chen-Stokes breathing may appear; Cianoz face; Nabult cervical veins. On the ECG, changes are characteristic of the underlying disease and inversion of g, depression of ST.

Complications: sympathy referee failure, hypertensive crisis, arrhythmia.

. - 50 μg in / in inkino with the transition to infusion, if it is impossible to / in administration - sublingual, starting from the first dose of 2.5 mg, then 05-1 mg every 5 minutes. With diabetes\u003e 160 mm Hg. Art. (diastolic pressure\u003e 130 mm Rg.st.) - nitroprusside sodium (except stenosis of the mouth of aorta) at a dose of 0.1-5 μg / kg / min or pentamine V / B - 50 mg / 20 ml in 10-20 min (50 mg / AMP).

It is possible to introduce morphine - 2-5 mg (10 mg / AMP) to / every 5-30 minutes to achieve the effect with careful control, it is necessary to ensure the possibility of intubating trachea.

Rtial stenosis and insufficiency: glycosides, in the absence of effect - nitroglycerin. It is possible to be extremely cautious administration of dobutamine 2-20 μg / kg / min (except for mitral stenosis) or amrinone (in the absence of effect or intoxication by glycosides) 0.75 mg / kg in 2-3 minutes, then 2-20 μg / kg / min. With the introduction of CSS vasodilators, it should not exceed the initial 10%. The introduction of glycosides depends on whether the edema of glycosidic intoxication is triggered or the situation requires additional use of the drug (not used with nausea, vomiting, atrial flickering with AV-blockade, frequent ventricular extrasystole or ventricular tachycardia, a trough-shaped segment of the S7 segment).

With pneumonia: glycosides, prednicular up to 2 mg / kg, furosemide up to 2 mg / kg. In severe cases, a pentamine or sodium nitroprusside can be used at bronchial asthma in conventional dosages.

Treatment of arrhythmia - Only an Eit. If the central venous pressure is below 5 cm water. ST. "The large volumes of crystalloids are introduced.

Easy swelling - emergency care, the main symptoms and methods of treating the disease.

Therapy helps to eliminate pulmonary edema. Emergency help: First aid algorithm.

Be sure to provide a person when attacking the edema of the lungs, a sedentary or a sudden position.

It is necessary to suck from the respiratory tract of the patient the existing liquid.

If pressure rises, then it is necessary to perform bloodletting. Children should produce up to two hundred milliliters of blood, adults - up to three hundred milliliters.

The imposition of the harnesses in the edema of the lung should be carried out on the feet (about thirty - sixty minutes).

With alcohol vapors, inhalation is carried out. For children, it is used thirty percent alcohol, and for adults - seventy percentage.

It is necessary to introduce two millilita of twenty percent camphor solution to subcutaneously.

The respiratory tract should be enriched with oxygen, for this is used oxygen pillow.

What drugs are used in pulmonary edema?

In addition, the edema of the lungs are effective are the means that reduce the hydration of pulmonary tissues, that is, dehydrating drugs.

Yes, it is possible to attribute the manit and urea. They are introduced intravenously, while the blood osmotic pressure increases, the water moves from the echo tissues into the vessels row. Mantite and urea solutions are used at pulmonary edema and edema of other tissues (mainly brain). Urea, in particular, manitis, have good diuretic activity. They contribute to the removal of fluid from the body, and the tissue hydration is reduced with their help. With a similar purpose in the case of edema of the lungs, such ammonic, active drugs, such as a stacriman acid and furosemide are prescribed.

Causes of edema development

Edema, which is sometimes called cardiac asthma, may be associated with the following reasons:

diseases of the circulatory system, in which blood is stared in a small circulation circle (any disease in the decompensation stage);
an overdose of drugs or narcotic substances;
formation of thrombus in the pulmonary artery;
poisoning of poisonous substances or toxic gases;
kidney pathology, under which the level of protein in the blood is reduced;
blood poisoning;
pneumonia;
hypertensive crisis;
blood stagnation in the right circle circulation is usually associated with bronchial asthma, emphysemic lungs and other diseases of the respiratory organs;
shock condition caused by injury;
radiation sickness.

Symptoms of edema

Excessive exercise, sharp change in body position or severe stress can provoke edema. When pathology is only born, a person feels shortness of breath and swear in his chest, breathing.

At the initial stage, the liquid is collected in the interstation of the lungs. This condition is accompanied by the following symptoms:

squeezing feeling in the chest;
frequent unproductive cough;
sharp pale of skin;
labored breathing;
tahipne;
the feeling of anxiety and panic, it is possible to confusion;
hypertension;
heart palpitations;
reinforced sweating;
bronchospasty syndrome.

When the liquid falls into the alveoli, the second stage begins - alveolar pulmonary edema. The patient sharply becomes worse. To reduce pain, the patient takes a seitant position, leaning on the elongated hands. This stage of edema is accompanied by the following symptoms:

coughing;
wet and dry wheems;
rapidness of shortness of breath;
bubber breathing;
suffocity increases;
cyanosis of the skin;
swollen cervical veins;
heartbeat is read up to 160 beats per minute;
consciousness is confused;
blood pressure drops;
the patient feels the fear of death;
fit-shaped and poorly talked pulse;
a foam pink wet is distinguished;
in the absence of timely medical care - a comatose state.

The attack can disrupt the integrity of the respiratory tract and lead to the death of the victim.

A person with pulmonary edema needs emergency care. It is necessary to take the following actions:

at the very first symptoms of cardiac asthma, call an ambulance aid;
help the patient to take a half-time or sedentary position, while its legs must be omitted;
put the legs of the patient in the pelvis with hot water;
open windows, giving victims to fresh air, remove or unbutton close, interfering breathing, clothing;
control the breath and pulse;
if there is a tonometer, measure blood pressure;
if the heart pressure is above 90, give a man one tablet nitroglycerin sublingual;
impose on venous harnesses on the feet to delay venous blood in them and reduce the load on the heart;
the harnesses are superimposed on the lower limbs in turn and can be on them not more than 20 minutes;
after normalizing the pressure to intravenously introduce the affected diuretics (for example, Laziks) to reduce the amount of fluid in the lungs;
inhalation of 96% (for children of 30%) with an aqueous solution of alcohol, which has an anti-inflationary effect.

After the above manipulations, it is necessary to wait for ambulance, which will be bought by swelling of the lungs and deliver the patient to intensive care. There, doctors determine what caused pathology, and the doctor of the corresponding specialty is engaged in further treatment.

Emergency medical care at swelling

Immediately after arriving, the ambulance doctors should introduce a patient with an edema of the lungs in Vienna a narcotic anesthetic agent (morphine, commotol) to normalize the hydrostatic pressure in the pulmonary circle of blood circulation, diuretic and nitroglycerin. When transporting to the hospital, the following actions are carried out:

the patient is placed so that the upper half of the torso is raised;
in the absence of diuretics on the lower limbs, turnstiles are superimposed, the pulse on the arteries should be maintained;
oxygen therapy is carried out (if required, the patient is injected into the trachea and artificial ventilation of the lungs is carried out);
the composition of the solution for inhalation should include a defoamer (70-96% aqueous solution of ethyl alcohol), which reduces the tension of the exudate;
every 30-40 minutes inhalation of the patient should breathe clean oxygen 10 minutes;
to remove the foam from the upper respiratory tract, electrotoxos is used;
if a thrombus formed in the pulmonary artery, anticoagulants that dilute blood are used;
if the patient has focusing arrhythmia, it is introduced by the drug from the cardiac glycoside group;
with nausea, vomiting or tachycardia of gastroats of glycosides can not be applied;
if the pulmonary edema is caused by the overdose of drugs, drugs that reduce the muscle tone are used;
in diastolic pressure, more than 100 requires 50 μg nitroglycerin intravenously;
with bronchospastic syndrome, a patient is given methylprednisolone or dexamethasone;
if the heart rate is less than 50 shots per minute, eutillin is used in combination with atropine;
if the affected bronchial asthma, he is introduced a standard dose of pentamine or sodium nitroprusside.

Therapy for edema

Further assistance in the edema of the lungs should be carried out by doctors from intensive care or intensive therapy. Monitoring pulse, pressure and breathing should be carried out constantly. All drugs are introduced through the catheter inserted into a subclavian vein.

After the swelling is stopped, the treatment of pathology begins, which caused it. For the treatment of edema of any origin, antibiotics and antiviral therapy are needed.

The diseases of the respiratory system are treated with antibiotics from the group of macrolides and fluoroquinolones, which have an expectorant and anti-inflammatory effect. Penicillin is rarely applied due to its low efficiency. Together with antibiotics, immunomodulators are prescribed, affecting the immune system and non-re-occurrence of infection.

If the edema is caused by intoxication, drugs are prescribed, removing symptoms and, if required, a controversial means. After diuretics, it is also necessary to restore the water-salt balance of the body.

From the severe form of acute pancreatitis, medicines depressing the work of the pancreas are eliminated. In addition, enzyme preparations and tools are prescribed to the healing of necrosis foci.

Asthma attacks are removed with glucocorticosteroids, bronchoditics, and well-diluted wet.

In cirrhosis, the liver is prescribed preparations for its protection and tioctic acid.

If the cause of pathology has become a myocardial infarction, beta-adrenoblasts are required, drugs that impede the formation of thromboms, and inhibitors of angiotensin gluttering enzyme.

The forecast after cardiac asthma is usually favorable, but the patient must pass at the attending physician during the year.

Possible complications after pulmonary edema

With illiterate first aid in the edema of the lungs, the person's condition may be aggravated and lead to complications:

pathology can move into a lightning form, and doctors will not have time to assist on time;
if too much foam is produced, it covers the respiratory tract;
with swelling, breathing is depressing;
cutting or commercial sore feeling behind the sternum can cause painful shock;
blood pressure with a significant amplitude drops, exposing blood vessels with a huge load;
significant increase in cardiac rhythm, stopping blood circulation.

Emergency prefigure

Firstly, with the development of the pulmonary edema before the arrival of the ambulance brigade, the patient must be taken a half-time position of the body, in which he wakes up much easier to inhale air, because in this position, the oxygen flow into the lung cavity is significantly improved. From the patient, it is necessary to remove the upper clothes, as well as completely free the area of \u200b\u200bthe chest. In the room, if possible, it is recommended to open the windows for fresh air access.

The main purpose of providing prefigure assistance should be aimed at preserving the respiratory function of the lungs. For this, it is necessary to urgently carry out the peak of speaking sputum or foam with the oral cavity. The most effective method in this case is 70% ethyl alcohol, which has a very good tivual action. For 5 - 7 minutes. The patient should unaccept the oxygen with alcohol couples. The procedure is necessary to repeat every 30 - 40 minutes.

The next step is a significant reduction in the receipt of venous blood into the lungs cavity (in order to reduce their further overfill), it is recommended to impose jutes to the top area of \u200b\u200bthe hips. JGUTH is necessary only for venous vessels, regularly checking the presence of ripples on the povered limbs. Also, it is necessary to record the uptaking time of JGUT (summer period - 2 hours; winter - maximum 1 h.) To prevent possible dieting tissues as a result of a long lack of blood circulation. After the expiration of this time, the JGUTH should be sent by about 5 to 7 minutes.

Next, it is necessary to make it necessary to drink 1 - 2 nitroglycerin tablets together with the validol under the tongue to prevent the possible development of myocardial infarction, as well as reduce the further progress of the escape zone of the pulmonary fabric. It is also recommended to heat hot water and make foot baths with mustard.

Before the arrival of the doctor, it is necessary to be constantly next to the sick, because it can become much worse at any time, right up to the complete loss of consciousness.

Pulmonary edema - pathological condition caused by the exceedment of the normal level of interstitial fluid.

Normal fluid exchange in lung fabric.

The lungs represent a complex of branched hollow tubes and tubes, "immersed" into the fabric. It is called interstice.

The interstice includes blood and lymphamitic vessels, connecting elements (cells and fibers), and intercellular fluid. All this is covered with a special shell, called visceral pleural.

The formation of this fluid occurs as a result of the exit of the blood vessels of the plasma part. It, in turn, is subjected to reverse absorption into lymphatic vessels. Which, fall into the upper hollow vein. Thus, the plasma filtrate is returned back.

The physiological meaning of this is that the intercellular fluid provides the delivery of nutrients and oxygen to the cells, and removing the exchange products.

Mechanisms of pulmonary edema.

There are only two mechanisms leading to a lung edema.

an increase in the amount of intercellular fluid by increasing the hydrostatic pressure in the blood vessels of the lungs. This is the so-called hydrostatic swelling.
increase in the amount of intercellular fluid due to excess plasma filtering at normal pressure. For example, the activity of inflammatory mediators - they increase the permeability of membranes. Moreover, both blood vessels and the aerhematics barrier - a membrane complex that limit blood vessels from the Alveol cavity.

This edema is called membrane.

Causes of lung edema

Depending on the type of pulmonary edema (membrane or hydrostatic), all reasons can be attributed to two groups.

AND). Causes causing hydrostatic pulmonary swelling.

These include all those associated with increasing pressure in the lung vessels.

diggle hearts in the decompensation stage. This is especially true of the insufficiency of the mitral valve, mitral and aortal stenosis.
embolia (blockage) of pulmonary vessels.
violation of the contractile ability of the heart. First of all, the swelling of the lungs occurs at left ventricular deficiency (left ventricle infarction), the overall lesion of myocardium (extensive heart attack with the development of cardiogenic shock), arrhythmias and blockades.
pneumothorax (air entering the pleural cavity).
acute respiratory failure. For example, with asthmatic status, the blockage of the foreign body of the respiratory tract or aspiration.

B). The causes of the membrane edema of the lungs.

nude: respiratory distress syndrome, aspiration, inhalation of some gases (chlorine, phosgene, carbafos, ozone, carbon monoxide, mercury pairs).
inflammatory: pneumonia, sepsis.

Symptoms of lung edema

This state is not so difficult to differentiate if it is good to know the symptoms of its manifestation.

First of all, in the speed of edema development, 4 forms are distinguished:

lightning room;
acute;
tray;
tighted.

The provoking factor in the development of edema can be physical activity, emotional stress, the transition of a person from the vertical position into horizontal. Sometimes, you can see the forerunners of developing edema, such as: increasing shortness of shortness of breath, breathing, frequent shames, appearance, or an increase in wet wheels.

The first symptoms of the starting acute edema will be: the appearance of pain in the chest, the feeling of its squeezing. Then the number of respiratory movements is studied, shortness of breath increases. Moreover, it is hard to breathe and exhale. The patient lacks air. Heartbeat is rapidly, cold sticky sweat appears on the skin. The color of the skin becomes bluish. The beginning of the attack is characterized by a dry cough, which, with the development of edema, is becoming wet, with a large number of wheezing and the release of the foamy sputum of pink color. In cases of heavy wet goes through the nose.

A typical symptom has a bubble breath - loud, frequent, intermittent. Man frightened. Possible confusion of consciousness. Blood pressure drops with increasing edema, the pulse becomes weak, filamentous.

With a lightning form, all these clinical manifestations are developing in minutes, and you can easily save the patient.

When subacute and protracted form, the symptoms develop slowly, gradually.

Development of edema of the lungs

Not depending on the reasons, swelling begins with increasing the amount of fluid in the intercellular space. As a result, there is a violation of the normal operation of cells and blood vessels. This is the so-called interstitial swelling of the lungs.

In the second stage, the liquid begins to penetrate the alveoli cavity, which reduces the gas exchange function. This is alveolar pulmonary swelling.

In the final, all alveoli becomes filled with liquid and turn off gas exchange. The body dies as a result of lack of oxygen.

Clinic edema lungs

At the stage of interstitial swelling of the patient concerns the feeling of the lack of air. It begins to sit down, since it is "easier to breathe."

Externally, it is possible to note the sinusiness of the lips, auscultative - wet worships in the lower departments of the lungs.

In the stage of alveolar edema, the patient can only sit, wet wheezing become audible not armed ear. So-called distant wheezes and bubbling breathing. Foam appears from the mouth, since the liquid that fell into the alveoli is in contact with the surfactant and air. As a result, it is foaming. The patient begins to "grab the air" mouth, lip sinusiness, serurn skin color with marble pattern.

Diagnosis of lung edema

The diagnosis is made on the basis of a clinical picture and symptoms. It is confirmed by: Auscultative - wet wet wipes and hard breathing, percussion - the dullness of the sound above the lungs; X-rayography, ECG and measuring FLOD.

Differential diagnosis

Differential diagnosis of pulmonary edema is carried out with:

bronchopneumonia;
thromboembolism of the pulmonary artery;
acute middle-vascular failure;
bronchial asthma;
bronchostatus.

First prefigure help with the edema of the lungs

If a person in consciousness needs to be moved to a vertical or sedentary position.
Provide fresh air access.
Estate shy clothes.
To dissolve nitroglycerin tablet and furosemide tablet.

Treatment of edema of the lungs

Treatment is aimed at normalization of pressure in a small circulation circle, reducing OPS, correction of KSHC disorders.

There are a number of priority actions that must be a patient with pulmonary edema.

Ensure the loss of respiratory tract, according to the intubation of the trachea.
If possible, give a sedentary position.
Inhalation of 100% oxygen through 96% PR-R foam alcohol.
The introduction of morphine intravenously.

Medical treatment.

intravenous administration of nitroglycerin patients with increased blood pressure.
intravenous administration of dopamine patients, with reduced blood pressure.
dorganic drugs: Furosemide or Laziks.
droperidol.
prednisolone.
pentamine - intravenously.
with low protein content in the blood - intravenous administration of albumin.

Employed edema - the pathological process, the emergence of which is associated with the yield of transudate of non-inflammatory origin from the capillaries in the interstitations of the lung, and after alveola. The result of such a process becomes a reduced performance of the alveoli and a violation of gas exchange, hypoxia is formed. In the gas composition of blood, significant changes also occur, since the content of carbon dioxide increases. In combination with hypoxia in a patient, a strong suppression of the capacity of the central nervous system. All this requires immediate medical care, otherwise the consequences may be the most deplorable.

Symptomatics

If it is possible to determine the symptoms of pathology on time, then urgent assistance in the edema of lungs will significantly reduce the risk of complications. If the disease is in the launched phase, then the patient is hampered by breathing due to shortness of breath. In this case, it does not matter, in what state is the patient: performs physical exertion or simply lies.

Employed edema - pathology, leading to oxygen starvation, which adversely affects the work of other organs. During the study with a stethoscope, you can hear wheezing by alveoli liquid accumulation.

In addition, the eighty edema can be recognized according to the following symptoms:

Dizziness - frequent symptom of pathology.
Often, on this background, the patient develops drowsiness and apathy.
If the disease takes a lightning form, then this is fraught with a suffocation that affects a person at night.
Cough, the formation of sputum, which over time becomes very liquid and resembles ordinary water.
Complete breathing, the presence of wipes and whistles.
Pallor of skin and increased sweating.

Very often in humans against the background of the disease happens, associated with the thoughts of death. The duration of the attack is 30 minutes, therefore, at this time, preference is very important. Only with its proper implementation, it is possible to avoid the death of the victim.

Classification of pathology

In addition to the specified symptoms, it is important to know the types of eighty edema:

Membranogenic - formed against the background of a sharp increase in permeability of capillaries. Such pathology is formed against the background of other syndromes.
Hydrostatic - amazes due to diseases for which a sharp increase in hydrostatic pressure in vessels is characterized. The liquid part of the plasma can exit such an amount in which it cannot be deduced through lymphatic pathways.

Correct status assessment

Taking into account the speed of transformation of the interstitial stage of the edema in the alveolar need to evaluate the condition of the victim. If there are chronic diseases, the development of the edema goes slowly and smoothly, more often at night. Such a pathological process can easily be eliminated by drug medicines. If the edema is caused by the vices of the mitral valve, the lesion of the light parenchyma, then there is an increase in its symptoms. The patient's condition is noticeably deteriorating. Pathology in acute form involves rapid response and first aid, since its development occurs very rapidly.

Prefigure help

Having found signs of the pathological process in a person, it is necessary to immediately begin to provide emergency care. In this case, the first assistance in the edema of the lungs implies the following algorithm of actions:

Squeeze the victim in a half-day position.
Remove foam from the upper respiratory tract. For these purposes, it is necessary to use oxygen inhalation after 33% ethanol.
Saving acute pain syndrome. In solving this issue, assistance will be neuroleptics.
Restore heart rhythm.
Adjust the electrolyte balance.
Normalize acid-alkaline balance.
Calculate the hydrostatic pressure in a small circulation of blood circulation. For this, such narcotic analgesics such as Gunnopon, Promedol. Their action is aimed at the oppression of the respiratory center, the elimination of tachycardia, a decrease in blood flow in veins, decreased blood pressure, reducing anxiety and fear of death.
Give the victim vasodilatory medicines. An excellent effect is an aerosol nitromint. When it is used, it is possible to reduce the tone of the vessels, the intrabriety volume of plasma. When using nitroglycerin drugs, it is possible to facilitate blood outflow from the lungs, affecting the peripheral resistance of the vessels.
An application of venous turnstiles on the lower limbs. Such events must be carried out in order to reduce the CCC. This method is actively used for several decades. To depend the parenchyma of the lungs, the Laziks are used in an amount of 40 ml. It is water intravenously. Its action is achieved over a couple of minutes, and lasts 3 hours. The drug is able to remove 2 liters of urins for a short time. With a reduced volume of blood and increased colloidal-osmotic pressure, the transition of the ethnic fluid into the bloodstream. Filtering pressure drops. To give the affected diuretics is permitted only after the hell normalized.
Introduction of heart glycosides in order to increase myocardial reductions.
Urgent hospitalization.

Emergency consequences

Often, when rendering a patient a prefigure aid, the condition may, on the contrary, aggravate and cause a number of the following complications:

Formation of a fleeting form of pathology.
Frequent foam generation causes the obstruction of the respiratory tract.
Breath depression.
Angry painful sensations. Such painful syndrome becomes simply unbearable, so the patient can form pain shock, which adversely affects the general forecast.
Hell can not stabilize. Often the course of pathology occurs on the background of low and high blood pressure. Indicators may be alternating within a significant amplitude. The vessels cannot withstand such a load, therefore there is a deterioration in the patient's condition.

Diseard therapy

After the first prefigible care of the patient, it is necessary to urgently hospitalize. Already in a hospital, the victim will prescribe the following treatment:

Inhalation of oxygen in combination with ethyl alcohol. Such events will contribute to the removal of foam from the lungs.
Anesthetic drugs and medicines to reduce psychomotor excitation. To reduce the hydrostatic pressure in the vessels of the affected organs and the decline in the influx of venous blood is prescribed morphine or fentanyl.
Diuretics whose action is aimed at reducing the volume of moving blood. Furosemide is considered effective, which carries out the dehydration of the lungs.
Cardiac glycosides help to achieve a cardiotonic effect. Assign Stroofantin and Corglikon.
To remove bronchospasm and in order to prevent the patient, the admission of euphilline and aminoophylline.
If there is an infectious disease, then without the antibiotics of a wide range of action here is not to do.

Empty edema is a very heavy and dangerous disease, since there is a risk of fatal outcome with emergency response. If all therapeutic activities were held on time and correctly, it is not worth worrying, since after effective therapy appointed by the doctor, the condition of the victim will noticeably improve.