[Severity factors and diagnosis of nonhemodynamic pulmonary edemas]

This syndrome is characterised by changes in the pulmonary capillary bed allowing filtration of edema fluid rich in proteins. It provokes an alveolo-capillary block and a fall in compliance. Positive diagnosis is envisaged from the clinical circumstances implicating a change in the pulmonary capillaries (blast, shock, microemboli). The fall in pO2 is early and intense. The fall in compliance is later and leads to hypoventilation necessitating ventilatory assistance. Diffuse radiological opacification of both pulmonary fields is characteristics, in its appearance and also in its prolonged course. In the differential diagnosis one should try to eliminate acute pulmonary edema and refractory hypoxia of bronchogenic origin. Prognosis of the condition is fixed by the course (of the pO2, of possible hypoventilation, of the radiological pictures), under treatment. Although persistance of the syndrome for more than one or two weeks is of bad prognosis, cases have been known to progress for more than three weeks and to heal leaving no after-effects. The syndrome can be complicated by cardiac incompetence, organic renal failure, which again aggravate the prognosis.