Edema Pulmonar Agudo: etiologia, diagnóstico e abordagens terapêuticas
DOI:
https://doi.org/10.5281/zenodo.12819717Palavras-chave:
Edema Pulmonar Agudo, Insuficiência Cardíaca, Prognóstico, Radiografia Torácica, TerapiaResumo
O Edema Pulmonar Agudo (EPA), caracterizado pelo acúmulo repentino de líquido nos pulmões, apresenta desafios clínicos significativos devido à sua rápida progressão e complexidade diagnóstica. Este artigo revisa a etiologia, métodos diagnósticos, opções terapêuticas e prognóstico dessa condição. Utilizando uma revisão narrativa da literatura, abordamos as principais causas, como insuficiência cardíaca e lesões pulmonares, e técnicas avançadas de diagnóstico, incluindo radiografia de tórax, tomografia computadorizada e ecocardiografia, que são cruciais para a identificação do líquido pulmonar e avaliação da função cardíaca. As opções terapêuticas variam desde a administração de oxigênio e diuréticos até intervenções mais invasivas, como ventilação mecânica e dispositivos de assistência ventricular. A escolha do tratamento é guiada pela gravidade dos sintomas e pela resposta inicial do paciente, enfatizando a importância de abordagens personalizadas e baseadas em evidências. Os estudos indicam que o prognóstico é geralmente positivo com diagnóstico precoce e tratamento adequado, embora persistam desafios na gestão de casos graves e prevenção de recorrências. Este artigo destaca a necessidade de pesquisas futuras focadas na otimização das estratégias diagnósticas e terapêuticas e na compreensão dos mecanismos patofisiológicos do EPA. Tais pesquisas são fundamentais para melhorar os desfechos clínicos e a qualidade de vida dos pacientes, promovendo inovações terapêuticas mais eficazes e menos invasivas, contribuindo assim para a literatura com uma visão abrangente sobre o Edema Pulmonar Agudo e a importância de avanços contínuos na área.
Referências
ABE, T.; TAKAGI, T.; FUJII, T. Update on the management of acute respiratory failure using non-invasive ventilation and pulse oximetry. Annual Update in Intensive Care and Emergency Medicine 2023, p. 165-175, 2023.
AKAR, A. R. et al. Systemic inflammatory response and cardiopulmonary bypass. In: Essentials of operative cardiac surgery. Cham: Springer International Publishing, 2023. p. 53-68.
AMADO-RODRÍGUEZ, L. et al. Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study. Journal of intensive care, v. 10, n. 1, p. 55, 2022.
AZHARUDDIN, Syed; YUNYONGYING, Pete. Predicting the risk of postoperative pulmonary complications. American Family Physician, v. 100, n. 8, p. 499-501, 2019.
BAID, H. et al. Point of care ultrasound as initial diagnostic tool in acute dyspnea patients in the emergency department of a tertiary care center: diagnostic accuracy study. International Journal of Emergency Medicine, v. 15, n. 1, p. 27, 2022.
BAZMPANI, M. A. et al. Contemporary data on the status and medical management of acute heart failure. Current Cardiology Reports, v. 24, n. 12, p. 2009-2022, 2022.
BERKMAN, N. Integrating Clinical, Laboratory and Imaging Tests in the Diagnosis of Pulmonary Embolism. Pulmonary Embolism, p. 119-128, 2022.
BISTOLA, V. et al. Inotropes in acute heart failure: from guidelines to practical use: therapeutic options and clinical practice. Cardiac failure review, v. 5, n. 3, p. 133, 2019.
BOS, L. D. J.; DE GROOTH, H. J.; TUINMAN, P. R. A structured diagnostic algorithm for patients with ARDS. Critical Care, v. 27, n. 1, p. 94, 2023.
CHIONCEL, O. et al. Pulmonary oedema—therapeutic targets. Cardiac Failure Review, v. 1, n. 1, p. 38, 2015.
CHU, Y. Non-cardiogenic Pulmonary Edema. Essential Radiology Review: A Question and Answer Guide, p. 233-236, 2019.
DAVISON, D. L.; TEREK, M.; CHAWLA, Lakhmir S. Neurogenic pulmonary edema. Critical care, v. 16, p. 1-7, 2012.
DOBBE, L. et al. Cardiogenic pulmonary edema. The American Journal of the Medical Sciences, v. 358, n. 6, p. 389-397, 2019.
ESSAM, A. et al. Non-Invasive Positive Pressure Ventilation or Standard Oxygen Therapy as Initial Treatment of Acute Cardiogenic Pulmonary Edema in ICU Patients. QJM: An International Journal of Medicine, v. 116, n. Supplement_1, p. hcad069. 015, 2023.
FUJISHIMA, S. Guideline-based management of acute respiratory failure and acute respiratory distress syndrome. Journal of intensive care, v. 11, n. 1, p. 10, 2023.
HERRERO, R.; SANCHEZ, G.; LORENTE, J. A. New insights into the mechanisms of pulmonary edema in acute lung injury. Annals of Translational Medicine, v. 6, n. 2, 2018.
ILES, K. E. et al. Reactive species and pulmonary edema. Expert review of respiratory medicine, v. 3, n. 5, p. 487-496, 2009.
JOHNSON, M. R. Acute pulmonary edema. Current Treatment Options in Cardiovascular Medicine, v. 1, p. 269-276, 1999.
KAKOUROS, N. S.; KAKOUROS, S. N. Non-cardiogenic pulmonary edema. Hellenic J Cardiol, v. 44, p. 385-391, 2003.
KOMIYA, K. et al. A systematic review of diagnostic methods to differentiate acute lung injury/acute respiratory distress syndrome from cardiogenic pulmonary edema. Critical care, v. 21, p. 1-10, 2017.
KWON, H. et al. Monitoring of pulmonary edema using ultrasound radiofrequency signal. Shock, v. 59, n. 1, p. 118-124, 2023.
LOZADA-MARTÍNEZ, I. D. et al. Neurogenic pulmonary edema in subarachnoid hemorrhage: relevant clinical concepts. Egyptian Journal of Neurosurgery, v. 36, p. 1-6, 2021.
MASIP, J. Non-invasive ventilation in acute pulmonary oedema: does the technique or the interface matter?. European Heart Journal Acute Cardiovascular Care, v. 10, n. 10, p. 1112-1116, 2021.
MOHSENIN, V. Practical approach to detection and management of acute kidney injury in critically ill patient. Journal of intensive care, v. 5, p. 1-8, 2017.
O'LEARY, R.; MCKINLAY, J. Neurogenic pulmonary oedema. Continuing Education in Anaesthesia, Critical Care & Pain, v. 11, n. 3, p. 87-92, 2011.
PICKKERS, P. et al. Acute kidney injury in the critically ill: an updated review on pathophysiology and management. Intensive care medicine, v. 47, n. 8, p. 835-850, 2021.
RACCA, F. et al. Invasive Mechanical Ventilation in Traumatic Brain Injured Patients with Acute Respiratory Failure. Reviews on Recent Clinical Trials, v. 18, n. 1, p. 3-11, 2023.
RENDEKI, S.; MOLNÁR, T. F. Pulmonary contusion. Journal of thoracic disease, v. 11, n. Suppl 2, p. S141, 2019.
SANTUS, P. et al. Acute dyspnea in the emergency department: a clinical review. Internal and Emergency Medicine, v. 18, n. 5, p. 1491-1507, 2023.
SARACEN, A. et al. Neurogenic pulmonary edema in aneurysmal subarachnoid hemorrhage. Advancements in Clinical Research, p. 35-39, 2016.
SEARS, S. P.; CARR, G.; BIME, C. Acute and chronic respiratory failure in cancer patients. Oncologic Critical Care, p. 445-475, 2020.
SHAW, S. M. et al. Immunological mechanisms of pentoxifylline in chronic heart failure. European journal of heart failure, v. 11, n. 2, p. 113-118, 2009.
SHIRAKABE, A. et al. Organ dysfunction, injury, and failure in cardiogenic shock. Journal of Intensive Care, v. 11, n. 1, p. 26, 2023.
VISCONTI, L. et al. Kidney-lung connections in acute and chronic diseases: current perspectives. Journal of nephrology, v. 29, p. 341-348, 2016.
VITAL, F. M. R.; LADEIRA, M. T.; ATALLAH, Á. N. Non‐invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane database of systematic reviews, n. 5, 2013.
WARLTIER, D. C. et al. The systemic inflammatory response to cardiac surgery: implications for the anesthesiologist. The Journal of the American Society of Anesthesiologists, v. 97, n. 1, p. 215-252, 2002.
WENG, C. L. et al. Meta-analysis: noninvasive ventilation in acute cardiogenic pulmonary edema. Annals of internal medicine, v. 152, n. 9, p. 590-600, 2010.
YANCY, C. W. et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation, v. 128, n. 16, p. 1810-1852, 2013.
ZANZA, C. et al. Cardiogenic pulmonary edema in emergency medicine. Advances in Respiratory Medicine, v. 91, n. 5, p. 445-463, 2023.
ZANZA, C. et al. Practical review of mechanical ventilation in adults and children in the operating room and emergency department. Reviews on Recent Clinical Trials, v. 17, n. 1, p. 20-33, 2022.
ZOCCALI, C.; PUNTORIERI, E.; MALLAMACI, F. Lung congestion as a hidden threat in end-stage kidney disease: a call to action. Nephrology Dialysis Transplantation, v. 28, n. 11, p. 2657-2660, 2013.
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2024 Journal of Social Issues and Health Sciences (JSIHS)
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.