Therapy of Pulmonary Edema

Abstract

Any rationale for therapy in patients with pulmonary edema depends on the therapeutic endpoint. As discussed earlier in this volume, there are several abnormalities of lung function, in addition to edema (that is, excess fluid in the lungs), that may be major contributors to the hypoxemia, so that if oxygenation is the variable used to assess the effectiveness of therapy, manipulations which reduce the amount of edema may not appear efficacious. It may well be that drugs that may improve airway function or alter functions of the pulmonary vasculature are therapeutic in some conditions even though they do not improve oxygenation or reduce the amount of edema. This article will deal only with therapies aimed at reducing the amount of edema in the lungs or preventing further accumulation of edema fluid. The discussion will present rationales based on what is known about the pathogenesis of pulmonary edema, discussed in the previous articles.