Pulmonary oedema

Pulmonary oedema is a broad descriptive term and is usually defined as an abnormal accumulation of fluid in the extra-vascular compartments of the lung 1.

One method of classifying pulmonary oedema is as four main categories on the basis of pathophysiology which include:

  • increased hydrostatic pressure oedema
  • permeability oedema with diffuse alveolar damage (DAD)
  • permeability oedema without diffuse alveolar damage  
  • mixed oedema due to simultaneous increased hydrostatic pressure and permeability changes

It can arise from a range of cardiogenic and non-cardiogenic causes.

Causes

The causes of non-cardiogenic pulmonary oedema can be recalled with the following mnemonic: NOTCARDIAC.

Plain radiograph

The chest radiograph still remains the most practical and useful method of radiologically assessing and quantifying pulmonary oedema 3-4.

Features useful for broadly assessing pulmonary oedema on a plain chest radiograph include:

There is a general progression of signs on plain radiograph that occur as the pulmonary capillary wedge pressure (PCWP) increases (see pulmonary oedema grading). Whether all or only some of these features can be appreciated on the plain chest radiograph depend on the specific aetiology 1. Furthermore, pulmonary oedema is usually a bilateral process, but it may uncommonly appear to be unilateral in certain situations and pathologies (see unilateral pulmonary oedema). 

General imaging differential considerations include other causes of diffuse air space opacification:

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Article Information

rID: 16256
System: Chest
Synonyms or Alternate Spellings:
  • Pulmonary edema
  • Lung oedema
  • Lung edema
  • Acute pulmonary oedema
  • Oedema of the lungs
  • Oedema of lungs
  • Edema of the lungs
  • Edema of lungs

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Cases and Figures

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    Case 1: high altitude pulmonary oedema
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    Case 2
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    Laryngospasm-indu...
    Case 3: laryngospasm induced - post obstructive
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    Case 4
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    Pulmonary oedema
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    Case 7: re-expansion oedema
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    Case 8: near drowning
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    Case 9
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    Case 11: with bat's wings
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    Case 12: cardiogenic pulmonary oedema
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    Case 13
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