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As pulmonary edema has a wide variety of causes and presentations, the outcome or prognosis is often disease-dependent and more accurately described in relation to the associated syndrome. It is a major health problem, with one large review stating an incidence of 7.6% with an associated in hospital mortality rate of 11.9%. [ 2 ]
Asthma is a common pulmonary condition defined by chronic inflammation of respiratory tubes, tightening of respiratory smooth muscle, and episodes of bronchoconstriction. [1] The Centers for Disease Control and Prevention estimate that 1 in 11 children and 1 in 12 adults have asthma in the United States of America. [1]
Childhood asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to recurrent episodes of wheezing, shortness of breath, chest tightness and coughing. Around 4.9 million children in the US suffer from asthma [1]. It is difficult to diagnose asthma in children younger than 6 years of age.
NPPE develops as a result of significant negative pressure generated in the chest cavity by inspiration against an upper airway obstruction. These negative pressures in the chest lead to increase venous supply to the right side of the heart while simultaneously creating more resistance for the left side of the heart to supply blood to the rest of the body (). [4]
The outcome of treatment is dependent on causality. Pulmonary Hemorrhage is present in 7 to 10% of neonatal autopsies, but up to 80% of autopsies of very preterm infants. [1] The incidence is 1 in 1,000 live births. [1] Pulmonary hemorrhage has a high mortality rate of 30% to 40%. [1]
Unlike pneumonia, asthma and COPD typically present with wheezing, pulmonary edema presents with an abnormal electrocardiogram, cancer and bronchiectasis present with a cough of longer duration, and pulmonary emboli present with acute onset sharp chest pain and shortness of breath. [9]
There is ongoing interest into establishing connections of cardiac asthma to abnormalities in bronchiole anatomy. [1] [4] Current evaluation has proposed multiple mechanisms for increased airway resistance, and focus is on four alternate explanations: Bronchoconstriction as a result of pulmonary edema. [2] [4]
As the lungs age, there is a gradual increase in the closing capacity (i.e. The small airways begin to collapse at a higher volume/before expiration is complete). This also occurs with certain disease processes, such as asthma, chronic obstructive pulmonary disease, and pulmonary edema.