The nature and significance of peribronchial cuffing in pulmonary edema

So-called "peribronchial cuffing" in acute pulmonary edema appears to be caused by edema involving the bronchila wall as well as the peribronchial interstitial space, and this was confirmed at autopsy in a patient with acute left heart failure. Edema of the bronchial wall indicates transdation from capillaries derived from the bronchial rather than the pulmonary atery, which may well explain all of the radiological manifestations of acute interstitial edema. The possible role of this circulation in the production of acute alveolar edema is also discussed. The significance of the bronchial artery circulation in the production of acute pulmonary edema warrants reevaluation.