Pulmonary Edema

The Daily Apple™© Volume 2, Number 10
October 3, 2013


The questions below were posed last month in association with a Lecture on Pulmonary Edema given by me to the residents, fellows and medical students on the Critical Care Service at Geisinger Medical Center.  If you would like to see the lecture, email me.

Oh, yes, by the way, I am required by Geisinger to tell you that the opinions expressed are strictly mine and based on the latest evidence ... in every sense of the term.  None of this is the opinion of, supplied by or belongs to Geisinger in any way.  Yes, I do share the information with Geisinger as a part of my Clnical, Administrative, Teaching and Research obligation.  In other words, I work for Geisinger.

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Introduction to Pulmonary Edema

Pulmonary Edema is, fundamentally, excess water in the lungs and this extra water interferes with normal lung function.  There are three fundamental pathophysiologic mechanisms that underlie pulmonary edema and they help us to group the pathology we find in clinical cases.  Pulmonary edema may be found in patients with normal pulmonary vascular pressures (NPPE or Normal Pressure Pulmonary Edema), high pulmonary vascular pressure (HPPE or High Pressure Pulmonary Edema), or a combination of the two (MPE or Mixed Pulmonary Edema).  These mechanisms help us distinguish and define the causes and proper treatment options.  All treatments are therapeutic trials and patients must be monitored closely to verify effectiveness, or change treatment, if ineffective.  Always go back to the patient (not the record) to verify effectiveness.

Questions Posed


Pulmonary Edema: Back to Basics QUESTIONS for interactive discussion and debate
September 2013 Geisinger Talk by Michael F. Mascia, MD, MPH

masciam@aol.com and Dr.Mike@ihealsolutions.com

©IHS Michael F. Mascia, MD, MPH Pulmonary Edema v972013

1. What is Pulmonary Edema?
2. What is Edema (oedema): Transudate vs Exudate?
3. What are the Symptoms of Pulmonary Edema?
4. What are the Clinical Signs of Pulmonary Edema?
5. What are the Causes of Pulmonary Edema?
6. What is Noncardiogenic pulmonary edema?
7. What is Cardiogenic Pulmonary Edema?
8. What is the pathophysiology leading to pulmonary edema: Cardiogenic vs Noncardiogenic vs Mixed?
9. How can you confirm your clinical diagnosis?
10. What is the treatment of Pulmonary Edema?
11. Is it cost effective?
12. What is the expected outcome after treatment for pulmonary edema?
13. What is the evidence to support your answers?
14. What is optimal cost effective care in Pulmonary Edema?


Have a great day and StepWisely®™© with us @ihealsolutions, Infinity Health Solutions and Veritas Health Care


Ciao for now,


Dr. Mike
Michael F. Mascia, MD, MPH