Neurogenic Pulmonary Edema

Excerpt

Neurogenic pulmonary edema (NPE) is a clinical condition that arises as acute respiratory distress taking place in conjunction with severe neurological damage/injury. By definition, this condition incorporates a clinical picture of a large accumulation of extra-vascular pulmonary fluid, of acute onset, always in the immediate outcome of serious central nervous system (CNS) lesions, mostly the brainstem. Shanahan first described acute neurogenic pulmonary edema in 1908.

This diagnosis necessitates the exclusion of other identifiable origins of pulmonary lesions or cardiovascular function that may accompany nervous system distress, for instance, broncho-pulmonary aspiration or ischemic, toxic or traumatic lesions of the heart and lungs.

If the standard clinical presentation is explicit, the diagnosis should be assumed when acute pulmonary edema is associated with CNS injury in the absence of primary pulmonary or cardiovascular injury; however, some ambiguity continues, particularly since the literature does not present a full comprehension of exact pathogenesis.