Pulmonary edema laboratory tests: Difference between revisions

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* Elevated concentration of [[troponin]], may suggestive of damage to [[myocytes]], as underlying cause of cardiogenic pulmonary edema.
* Elevated concentration of [[troponin]], may suggestive of damage to [[myocytes]], as underlying cause of cardiogenic pulmonary edema.


==== shunt fractions (Qs/Qt): ====
==== Shunt fractions (Qs/Qt): ====
*  Patients characterized by non-cardiogenic pulmonary edema had greater shunt fractions(Qs/Qt) for any given level of respiratory index (A-aO/PaO2) than patients with cardiogenic pulmonary edema.<ref name="pmid448782">{{cite journal |vauthors=Siegel JH, Giovannini I, Coleman B |title=Ventilation:perfusion maldistribution secondary to the hyperdynamic cardiovascular state as the major cause of increased pulmonary shunting in human sepsis |journal=J Trauma |volume=19 |issue=6 |pages=432–60 |date=June 1979 |pmid=448782 |doi= |url=}}</ref>
*  Patients with non-cardiogenic pulmonary edema had greater shunt fractions(Qs/Qt) than patients with cardiogenic pulmonary edema.<ref name="pmid448782">{{cite journal |vauthors=Siegel JH, Giovannini I, Coleman B |title=Ventilation:perfusion maldistribution secondary to the hyperdynamic cardiovascular state as the major cause of increased pulmonary shunting in human sepsis |journal=J Trauma |volume=19 |issue=6 |pages=432–60 |date=June 1979 |pmid=448782 |doi= |url=}}</ref>
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{| border="1"
|+ Differentiation of cardiogenic pulmonary edema and noncardiogenic pulmonary edema
|+ Differentiation of cardiogenic pulmonary edema and noncardiogenic pulmonary edema

Revision as of 16:12, 23 February 2018

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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

Laboratory Findings

Laboratory findings consistent with the diagnosis of pulmonary edema include:[1][2][3]

Arterial blood gas test:

Serum albumin:

  • Albumin may be low in pulmonary edema

Liver function tests:

Plasma brain natriuretic peptide levels :

  • 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.

Cardiac enzymes:

  • 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.[4]
Differentiation of cardiogenic pulmonary edema and noncardiogenic pulmonary edema
Laboratory findings Cardiac enzymes BNP PCWP QS/QT Edema fluid/serum protein
Cardiogenic pulmonary edema May be elevated High >18 mmHg Small elevated <.5
Noncardiogenic pulmonary edema Usually normal Low <18 mmHg Large elevated <.7

References

  1. 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.
  2. 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.
  3. Murray JF (February 2011). "Pulmonary edema: pathophysiology and diagnosis". Int. J. Tuberc. Lung Dis. 15 (2): 155–60, i. PMID 21219673.
  4. 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.


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