How to deal with pulmonary edema -- lower limbs to droop?

summary

Pulmonary edema is due to poor cardiac function caused by a serious lung water phenomenon, serious can lead to dyspnea, phlegm cough, phlegm with blood and other phenomena, the following describes how to do pulmonary edema.

How to deal with pulmonary edema -- lower limbs to droop?

First: swelling and edema in patients with mild general measures can be used. Take half sitting position, two lower limbs droop, if necessary, limbs alternate restraint tourniquet, in order to reduce the amount of venous blood, reduce cardiac preload. The central venous pressure monitoring should be used to guide fluid infusion during anti shock treatment. If possible, the pulmonary capillary wedge pressure or pulmonary artery diastolic pressure should be monitored by floating catheter, so as to avoid a large amount of fluid into the pulmonary circulation by mistake and aggravate pulmonary edema. In addition to hypoproteinemia, it is generally not appropriate to infuse colloidal solution such as serum albumin or high molecular dextran, so as not to hinder the absorption of edema.

Second: moderate edema patients can also use oxygen therapy and improve gas exchange methods, hypoxia is a serious pathological state of acute pulmonary edema, and can promote the further deterioration of pulmonary edema, so it is very important to correct hypoxia. Only * PaO2<7.98kPa, without carbon dioxide retention, can be supplied by nasal obstruction, nasal catheter or mask. The oxygen flow rate will start from 2 to 3L/min. After the patient has adjusted, it will increase to 5 to 6L/min, or be applied according to the specific conditions of the patient. More than 60% high concentration oxygen can be used for severe hypoxia, but oxygen poisoning should be paid attention to. In order to eliminate foam, oxygen can be inhaled by using 50% to 70% alcohol humidifying bottle and 1% silicone or two methyl silicone oil.

Third: for patients with severe pulmonary edema, especially for non cardiogenic pulmonary edema, the effect of general oxygen therapy is often not ideal, which can not quickly improve the arterial partial pressure of oxygen to a safe level, and mechanical respiration is often required with oxygen therapy. If there is no chronic obstructive pulmonary disease, high frequency ventilator jet ventilation can be given. Intermittent positive pressure breathing (IPPB) or bi level positive airway pressure breathing (BI Pap) can be used in patients with no effect. If the improvement of hypoxia is still not obvious, positive end expiratory pressure (PEEP) can be used instead. The end expiratory pressure gradually increases from small to large to about 0.98kpa, and the oxygen concentration is about 40%. Blood gas monitoring is carried out to keep the arterial partial pressure of oxygen at 8-9.33kpa. When the patient's condition improves and the lung compliance increases, the end expiratory pressure should be gradually reduced so as not to affect the cardiac output.

matters needing attention

Diet should avoid fatty, sweet sticky, fried, dry, sour and astringent food; strictly avoid seafood, wine and spicy food.