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Pulmonary oedema

Oedema pulmonum · Plicní edém

What it is

Fluid floods the alveoli, usually because the left heart is failing.

Symptoms & signs

  • Severe breathlessness
  • pink frothy sputum
  • drowning sensation
  • can't lie flat
  • crackles everywhere

🚩 Get help if…

  • call 112 / 911 now Severe breathlessness, worse lying flat
  • call 112 / 911 now Coughing up frothy pink phlegm
  • see a doctor soon Waking at night gasping for breath
  • see a doctor soon Weight up 2 kg in 3 days, or swollen ankles

Where it strikes

Medical treatment

  • Sit up, high-flow oxygen or CPAP
  • IV furosemide
  • nitrates
  • treat the cause
  • ventilation if failing
  • Pulmonary artery pressure sensor (CardioMEMS) in heart failure — FDA-approved 2014; fewer admissions in the CHAMPION trial

Natural & lifestyle

  • Salt restriction
  • daily weights
  • fluid limits after recovery

Emerging & experimental

  • Ultrafiltration

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Coenzyme Q10 in heart failure — the Q-SYMBIO trial found fewer cardiac deaths; not yet repeated mixed evidence
  • Hawthorn (Crataegus) — better exercise tolerance in small trials; no effect on events in the large SPICE trial mixed evidence
  • Sleeping propped up and cutting salt drastically — common sense, untested beyond what doctors already advise anecdotal / traditional

ICD codes