Treatment
Acute pulmonary edema is a dangerous condition that warrants rapid hospitalization and treatment. Before correcting the precipitating factors, resuscitative steps must be undertaken quickly. The primary step is to secure an open, clear airway. This may be achieved by simply encouraging the patient to cough, or may require the physician to perform a maneuver such as the Heimlich maneuver.
The second step is to administer oxygen, which restores the normal oxygen saturation of the blood. This is usually given by face mask or nasal prongs.
The third step is to administer drugs to decrease the load on the heart. These medications achieve the desired outcome through a variety of mechanisms. Diuretics increase the volume of urine, siphoning excess fluid from the circulation. Angiotensin Converting Enzyme Inhibitors (ACE inhibitors) and Angiotensin II Receptor Blockers (ARBs) halt the RAAS system of the kidneys, preventing them from increasing the blood volume to the detriment of cardiac function.
After the patient is stabilized, attention should be shifted towards the cause of the acute pulmonary edema. Each condition requires a specific treatment, which may be medical or surgical. For example, patients with incompetent heart valves may need a heart valve replacement operation. People with arrhythmia need to be maintained on anti-arrhythmic medication. Someone with an acute myocardial infarction would need thrombolytics or a PCI (Percutaneous Coronary Intervention), followed by antiplatelet and anticoagulant drugs.
