Pulmonary edema laboratory tests
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Editor-In-Chief: C. Michael Gibson, M.S., M.D.  Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD 
Laboratory findings consistent with the diagnosis of pulmonary edema include hypoxia, hypercapnia, acidosis. Elevated B-type natriuretic peptide (BNP) and cardiac enzyme is usually suggestive of cardiogenic pulmonary edema.
Laboratory findings consistent with the diagnosis of pulmonary edema include:
Arterial blood gas test:
- Oxygen saturation < 90%
- PaO2 < 60 mm Hg
- CO2 > 45–55 mm Hg
- PH < 7.35 nEq/liter
- Early ﬁndings of pulmonary edema may be respiratory alkalosis because of hyperventilation
- Albumin may be low in pulmonary edema
Liver function tests:
- Elevation in alanine aminotransferase, aspartate aminotransferase and bilirubin may be seen in right ventricular failure as underlying cause of cardiogenic pulmonary edema
Plasma brain natriuretic peptide levels :
- B-type natriuretic peptide (BNP) is elevated in the patient with cardiogenic pulmonary edema.
- A low BNP (<100 pg/ml) makes a cardiac cause very unlikely and is associated with non-cardiogenic pulmonary edema.
Pulmonary capillary wedge pressure(PCWP):
- A wedge pressure of 18 mmHg or higher is usually suggestive of cardiogenic pulmonary edema.
- A wedge pressure of less than 18 mmHg is usually suggestive of non-cardiogenic pulmonary edema.
- Elevated concentration of troponin, may suggestive of damage to myocytes, as underlying cause of cardiogenic pulmonary edema.
Shunt fractions (Qs/Qt):
- Patients with non-cardiogenic pulmonary edema had greater shunt fractions(Qs/Qt) than patients with cardiogenic pulmonary edema.
|Laboratory findings||Cardiac enzymes||BNP||PCWP||QS/QT|
|Cardiogenic pulmonary edema||May be elevated||High||>18 mmHg||Small elevated|
|Noncardiogenic pulmonary edema||Usually normal||Low||<18 mmHg||Large elevated|
- ↑ Ware LB, Matthay MA (December 2005). "Clinical practice. Acute pulmonary edema". N. Engl. J. Med. 353 (26): 2788–96. doi:10.1056/NEJMcp052699. PMID 16382065.
- ↑ Sibbald WJ, Cunningham DR, Chin DN (October 1983). "Non-cardiac or cardiac pulmonary edema? A practical approach to clinical differentiation in critically ill patients". Chest. 84 (4): 452–61. PMID 6617283.
- ↑ Murray JF (February 2011). "Pulmonary edema: pathophysiology and diagnosis". Int. J. Tuberc. Lung Dis. 15 (2): 155–60, i. PMID 21219673.
- ↑ Siegel JH, Giovannini I, Coleman B (June 1979). "Ventilation:perfusion maldistribution secondary to the hyperdynamic cardiovascular state as the major cause of increased pulmonary shunting in human sepsis". J Trauma. 19 (6): 432–60. PMID 448782.