PATHOGENESIS OF PULMONARY-EDEMA ASSOCIATED WITH THE ADULT RESPIRATORY-DISTRESS SYNDROME

  • 1 January 1979
    • journal article
    • review article
    • Vol. 120  (4) , 445-450
Abstract
Pulmonary edema is a common cause of acute respiratory failure and can be seen if not only cardiac but also noncardiac diseases. The pathophysiologic mechanism for the development of acute pulmonary edema in any clinical situation can usually be explained by alterations in the forces governing the transvascular flux of fluid in the pulmonary microvasculature, according to the Starling equation. Cardiac pulmonary edema is primarily due to an increase in the capillary hydrostatic pressure of sufficient magnitude to overcome the forces maintaining fluid within the vessel and the ability of the lymphatics to drain the transudated fluid. On the other hand, pulmonary edema occurring in association with noncardiac disease (e.g., sepsis, aspiration or shock) is secondary to an increase in the permeability of the pulmonary microvasculature and is referred to as noncardiogenic pulmonary edema or the adult respiratory distress syndrome. This article examines the mechanisms for the development of pulmonary edema and discusses the differences between the cardiac and noncardiac types.