Pulmonary edema primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]

Overview

Effective measures for the primary prevention of cardiogenic pulmonary edema include maintaining a healthy lifestyle, avoid tobacco, treat dyslipidemia, low salt diet, controlling hypertension, avoid cardiotoxic agents, controling diabetes. Effective measures for the primary prevention of high-altitude pulmonary edema include, encourage healthy lifestyle and exercise, gradual ascent, preacclimization, avoiding alcohol ingestion, high carbohydrate in diet, adequate hydration, vigorous exertion during the first few days at high altitude, oxygen enrichment.

Primary Prevention

Cardiogenic pulmonary edmea

Cardiogenic pulmonary edema is due to heart-related illnesses. Primary prevention include:

• Maintaining a healthy lifestyle
• Avoid tobacco
• Treat dyslipidemia
• Low salt diet

• Controlling hypertension
• Avoid cardiotoxic agents

• Controling diabetes

Consider additional measures in selected patients:

• Administer ACE-I if history of myocardial infarction or acute coronary syndrome and reduced ejection fraction to prevent symptoms and reduce mortality
• Administer beta-blockers if history of myocardial infarction or  acute coronary syndrome and reduced ejection fraction to reduce mortality 
• Administer statins if history of myocardial infarction or acute coronary syndrometo prevent symptoms
• Consider ICD placement to prevent sudden death if one of the following:
  • Asymptomatic ischemic cardiomyopathy
  • > 40 days post-MI
  • LVEF ≤30%
  • On adequate medical therapy
  • Good 1 year survival

Non-cardiogenic pulmonary edema

• High-altitude pulmonary edema
  • Effective measures for the primary prevention of altitude sickness include:
    • Encourage healthy lifestyle and exercise
    • Gradual ascent
    • Pre-acclimatization 
    • Avoiding alcohol ingestion
    • High carbohydrate in diet
    • Adequate hydration
    • Vigorous exertion during the first few days at high altitude
    • Oxygen enrichment
    • Druges
      • Ibuprofen
      • Acetazolamide
      • Sumatriptan
      • Sprinolactone
      • Steroids

• Acute respiratory distress syndrome
  • For more information about primary intervention in acute respiratory distress syndrome click here.