Why do the lungs fill with fluid?
There is a thin barrier between the capillaries of the lungs and the air sacs through which only gas normally passes. If the pressure in the pulmonary capillaries increases sharply, the liquid part of the blood is forced outward - first into the interstitial space, then into the alveoli themselves, and gas exchange stops. This mechanism is typical for cardiac causes. In the non-cardiogenic variant, the pressure is normal, but the capillary wall itself is damaged and it becomes permeable: this happens with severe infection, inhalation of toxic gases, drowning, pancreatitis.
- Increased pressure in the pulmonary capillaries due to cardiac causes
- Damage to the capillary wall in a non-cardiogenic variant
- Sweating of fluid into the alveoli
- Stopping normal gas exchange
- Increasing oxygen starvation
Reasons
In the first place are heart diseases: acute or decompensated heart failure, myocardial infarction, severe hypertensive crisis, valve defects, rhythm disturbances. Frequent provocateurs are violation of the treatment regimen, excess salt and fluid, previous infection, and anemia. Non-cardiogenic causes include severe pneumonia and sepsis, kidney failure, poisoning, severe trauma, and altitude sickness in unprepared people in the mountains. The separation is important because diuretics do not help with all forms.
- Acute and decompensated heart failure
- Myocardial infarction
- Hypertensive crisis
- Valve defects and rhythm disturbances
- Severe pneumonia, sepsis
- Kidney failure and fluid overload
- Poisoning, inhalation of irritating gases
- High altitude pulmonary edema
How to recognize an attack
Usually it all starts suddenly, often at night: a person wakes up from lack of air, sits down, dangles his legs and leans on his hands - in this position it is easier to breathe. Breathing becomes frequent and noisy, a cough appears, first dry, then with foamy sputum, sometimes pink due to blood. The skin is pale, covered in cold sweat, the lips turn blue, and the feeling of fear increases. The pulse is frequent, the pressure can be both high and low. The condition is deteriorating very quickly, so it is impossible to wait for improvement.
- Sudden night suffocation
- Forced sitting position
- Bubbling noisy breathing
- Foamy, sometimes pink sputum
- Cold sweat, pallor, blue lips
- Severe anxiety and fear
- Frequent pulse
First aid before the ambulance arrives
The main thing is to immediately call 103 and not try to cope on your own. Before the team arrives, the person is seated with his legs down, his clothes are unbuttoned, and fresh air is provided. You can’t lay it horizontally: lying down makes suffocation worse. Do not give food or drink. If the doctor has previously prescribed medications for emergency situations and the patient is conscious, they are used strictly according to the doctor’s previous instructions; It is dangerous to pick up someone else’s medicines yourself. It is important to find and provide doctors with a list of medications taken and previous examinations.
- Call 103 immediately
- Sit down, lower your legs down
- Unbutton your clothes, open the window
- Do not lay horizontally
- Don't give anything to drink or eat
- Do not give other people's drugs
- Prepare documents and a list of medications
Treatment and prevention of recurrences
Help is provided in the hospital: oxygen is given, non-invasive ventilation is used if necessary, diuretics and drugs are administered that reduce the load on the heart, while eliminating the cause - they restore blood flow during a heart attack, reduce pressure during a crisis, and restore rhythm. After stabilization, the main task is to prevent recurrence. To do this, the treatment regimen for heart failure is reviewed, the patient is taught to weigh himself daily and keep a blood pressure diary, and salt is limited. A sharp weight gain over several days is an early signal of fluid retention, in which case you need to contact your doctor without waiting for suffocation.
- Oxygen and respiratory support
- Diuretics and heart relievers
- Treatment of the cause: heart attack, crisis, arrhythmia, infection
- Daily weighing and blood pressure diary
- Limiting salt and controlling fluid intake
- Accurate adherence to the prescribed drug regimen
- Scheduled visits to the cardiologist, flu vaccination