Pulmonary Edema

WHAT YOU SHOULD KNOW:

• Pulmonary edema is a buildup of fluid in the alveoli (air sacs) of your lungs. Pulmonary edema occurs when increased fluid is pushed into the alveoli faster than it is moved out. Your lungs are organs in your chest that fill with oxygen when you breathe in. Air enters your lungs through your airways (tubes) until it reaches tiny sacs called alveoli. Your alveoli then take the oxygen from the air and send it to your blood. The alveoli also exchange (trade) the oxygen for carbon dioxide (unoxygenated gas). You are then able to breathe the carbon dioxide out of your body.
  
  
• When you have pulmonary edema, the fluid in the alveoli makes it hard for the alveoli to fill with air. This can make it harder for you to breathe and may decrease the oxygen in your blood. If your body cannot get enough oxygen, your tissues and organs may not work as they should. You may have pulmonary edema if you have heart failure or another heart condition, a lung injury, or a blocked airway. You may also get pulmonary edema if you climb to high altitudes (heights) too quickly. You may need blood tests, a chest x-ray, or echocardiogram to diagnose your pulmonary edema and its cause. Treatment includes bed rest, medicines, and breathing assistance, such as oxygen or a ventilator. Treating your pulmonary edema may help decrease the fluid in your alveoli. This may help your lungs work normally, allowing your body to get the oxygen it needs to function properly.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Medicines used to treat your pulmonary edema may cause dizziness, headaches, low blood pressure, and kidney problems. The levels of potassium in your blood may change and lead to abnormal heartbeats. Your heart may beat too quickly or too slowly. If you are wearing an oxygen mask, it may be uncomfortable and you may have trouble talking. Your nose or the skin on your face may get dry, sore, and red. If you need an ET tube and ventilator to breathe, your throat may be injured when the ET tube is put in. You will not be able to speak or eat while the ET tube is in place. You may also get a lung or sinus infection and your heartbeat may become irregular.
  
  
• Pulmonary edema can be a serious, life-threatening condition. Without treatment, your symptoms, such as trouble breathing and chest discomfort, may get worse. You may get more tired from a lack of oxygen and you may go into a coma. A coma is when you look like you are sleeping but cannot be woken up. Your heart may not pump as it should and your body may not get the oxygen it needs to function. If you do not get treatment for your pulmonary edema, you may die. Talk with your caregiver if you have questions or concerns about your condition, treatment or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Intake and output:

Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

Weight:

You may be weighed each day. Caregivers compare your weight from day to day. This helps caregivers see how much body fluid you have. When you lose too much body fluid you can become dehydrated. If you have too much body fluid, you may have trouble breathing and get swollen ankles. Your body does not work well when it has too much or too little fluid.

Medicines:

• Diuretics: This medicine is given to decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. It is often called water pills. You may urinate more often when you take this medicine.
  
  
• Morphine: This medicine helps decrease your pain. It also may help you breathe easier. Morphine helps tiny blood vessels in your lungs open wider. This lets your blood pick up more oxygen, and your breathing may become easier.
  
  
• Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.
  
  
• Vasodilators: Vasodilators may improve blood flow by making the blood vessels in your heart and lungs wider. This may decrease the pressure in your blood vessels and improve your symptoms.

Monitoring:

• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Pulmonary artery line: A pulmonary artery line, or PA cath, is a kind of central line catheter. It is a thin tube put in a vein near your collarbone, or in your neck or groin. The tube is then guided through your heart and into a blood vessel that goes to your lungs. One end of this catheter is hooked to a machine called a monitor. The monitor shows numbers that tell caregivers how your heart and lungs are doing. The part of this catheter that is inside you may be used to give you medicine. You will need a chest x-ray after the PA line is placed, to be sure the line is where your caregiver wants it. You may have stitches on your skin where the line comes out. This holds the line in place.

Tests:

• Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Chest x-ray: A chest x-ray is a picture of your heart and lungs. Caregivers use the x-ray to check the size of your heart. A chest x-ray may also show fluid around your heart and lungs.
  
  
• Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.

Treatment options:

• Rest: Keep the head of your bed raised to help you breathe easier. You can also raise your head and shoulders up on pillows or rest in a reclining chair. If you feel short of breath, let caregivers know right away.
  
  
• Breathing assist: You may need the following treatments if you are not getting enough oxygen on your own:
  
  
  • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
    
    
  • Noninvasive positive pressure ventilation: Noninvasive positive-pressure ventilation, or NPPV, may help you breathe without using a breathing tube in your throat. Instead, a machine helps your lungs fill with air through a mask or a mouthpiece. If a mask is used, it may go over your nose and mouth, or just your nose. Extra oxygen may also be given to you through the machine.
    
    
  • Ventilator: A ventilator is a machine that can breathe for you if you cannot breathe well on your own. You may have an endotracheal (ET) tube in your mouth or nose. The ET tube is hooked to the ventilator.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Pulmonary Edema (Inpatient Care)