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Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
Pulmonary edema in near hanging
Stalin Viswanathan1, Vivekanandan Muthu, Bhavith Remalayam
1Department of Internal Medicine, Pondicherry Institute of Medical Sciences, Kalapet Pondicherry, South India. stalinviswanathan@ymail.com
The Journal of Trauma and Acute Care Surgery
|February 8, 2012
Summary
Pulmonary edema occurred in near-hanging patients, often due to cardiac or neurogenic factors. Supportive therapy effectively treated these cases without increasing mortality.
Area of Science:
- Cardiology
- Pulmonology
- Emergency Medicine
Background:
- Near-hanging incidents can lead to various medical complications.
- Pulmonary edema is a significant concern in patients surviving near-hanging events.
Purpose of the Study:
- To investigate the incidence and outcomes of pulmonary edema in near-hanging survivors.
- To identify potential causes and effective treatments for pulmonary edema in this patient group.
Main Methods:
- Retrospective analysis of 19 near-hanging cases admitted to the Emergency Department.
- Data collected included pulmonary edema occurrence, electrocardiographic changes, echocardiography findings, cardiac enzymes, and interventions like mechanical ventilation, inotropes, mannitol, and steroids.
Main Results:
- Seven patients (37%) developed clinical and radiologic pulmonary edema.
- Mannitol use precipitated edema in four patients; inotropes and mechanical ventilation were used in three.
- Three patients with edema showed electrocardiographic and echocardiographic changes that resolved before discharge.
Conclusions:
- Pulmonary edema in near-hanging survivors can stem from neurogenic, cardiogenic, or postobstructive causes, with Takotsubo cardiomyopathy/myocardial stunning being common.
- Pulmonary edema occurrence was independent of consciousness level or ECG changes and was not associated with mortality.
- Supportive therapy is effective for treating pulmonary edema in near-hanging victims.
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