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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2019

Open Access 01-12-2019 | Pulmonary Edema | Case report

Prolonged respiratory failure due to pulmonary embolism in a young woman: a case report

Authors: Daniel Tuchscherer, Alexa Hollinger, Jens Bremerich, Martin Siegemund

Published in: Journal of Medical Case Reports | Issue 1/2019

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Abstract

Background

The pathophysiology of pulmonary edema is generally considered to result from elevated pulmonary capillary hydrostatic pressure due to increased left atrial pressure in consequence of a failing left ventricle.

Case presentation

We present a case of pulmonary edema secondary to severe hypalbuminemia under excessive respiratory drive in a 29-year-old Caucasian woman in respiratory distress with detected bilateral central pulmonary embolism.

Conclusion

In conjunction with severe hypalbuminemia, even the negative intrathoracic pressure swings of respiratory distress may cause pulmonary edema. Detrimental consequences of non-invasive ventilation due to uncontrolled tidal volume and pressure swings need to be considered when treating patients in hypoxemic respiratory failure with low serum albumin.
Footnotes
1
Q = Kf [(Pc–Pi) - Kπ (πc-πi)]
Starling’s equation, where Q is the net fluid flow across the pulmonary capillary wall, Kf is the filtration coefficient (a measure of the permeability of the pulmonary capillary wall to fluid flux across it), Kπ is the oncotic reflection coefficient (a measure of the pulmonary capillary wall resistance to protein movement), Pc is the pulmonary capillary hydrostatic pressure, Pi is the pulmonary interstitial hydrostatic pressure, πc is the capillary oncotic pressure, and πi is the interstitial oncotic pressure
 
Literature
1.
Guyton AC, Lindsey AW. Effect of elevated left atrial pressure and decreased plasma protein concentration on the development of pulmonary edema. Circ Res. 1959;7(4):649–57.CrossRef
2.
Taylor AE. Capillary fluid filtration. Starling forces and lymph flow. Circ Res. 1981;49(3):557–75.CrossRef
3.
Thoma P, Rondelet B, Mélot C, Tack D, Naeije R, Gevenois PA. Acute Pulmonary Embolism: Relationships between Ground-Glass Opacification at Thin-Section CT and Hemodynamics in Pigs. Radiology. 2009;250(3):721–9.CrossRef
4.
MacIver DH, Clark AL. The Vital Role of the Right Ventricle in the Pathogenesis of Acute Pulmonary Edema. Am J Cardiol. 2015;115:992–1000.CrossRef
5.
Ehrhart C, Hall JE, Hofman WF. Vascular pressure effects on lung edema formation after glass bead embolism. J Appl Physiol. 1987;62(5):1989–96.CrossRef
6.
Elliott CG. Pulmonary physiology during pulmonary embolism. Chest. 1992;101(4 Suppl):163S–71S.CrossRef
7.
Nelson JR, Smith JR. The pathologic physiology of pulmonary embolism. A physiologic discussion of the vascular reactions following pulmonary arterial obstruction by emboli of varying size. Am Heart J. 1959;58:916–32.CrossRef
8.
Lemyze M, Mallat J. Understanding negative pressure pulmonary edema. Intensive Care Med. 2014;40(8):1140–3.CrossRef
9.
Arques S, Ambrosi P, Gelisse R, Luccioni R, Habib G. Hypoalbuminemia in elderly patients with acute diastolic heart failure. J Am Coll Cardiol. 2003;42(4):712–6.CrossRef
10.
Arif SK, Verheij J, Groeneveld AB, Raijmakers PG. Hypoproteinemia as a marker of acute respiratory distress syndrome in critically ill patients with pulmonary edema. Intensive Care Med. 2002;28(3):310–7.CrossRef
11.
Bhattacharya M, Kallet RH, Ware LB, Matthay MA. Negative-Pressure Pulmonary Edema. Chest. 2016;150(4):927–33.CrossRef
12.
Brochard L, Slutsky A, Pesenti A. Mechanical Ventilation to Minimize Progression of Lung Injury in Acute Respiratory Failure. Am J Respir Crit Care Med. 2017;195(4):438–42.CrossRef
Metadata
Title
Prolonged respiratory failure due to pulmonary embolism in a young woman: a case report
Authors
Daniel Tuchscherer
Alexa Hollinger
Jens Bremerich
Martin Siegemund
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2019
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-019-2169-6

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