title: Respiratory failure in the neurological patient: the diagnosis of neurogenic pulmonary edema.
abstract: Neurogenic pulmonary edema (NPE) is a potential complication of a central nervous system (CNS) insult such as intracranial hemorrhage, uncontrolled generalized seizures, head trauma, tumors, and neurosurgical procedures. The proposed etiology is massive sympathetic discharge following a CNS event. The pathogenesis is not completely understood. However, there are two theories on how NPE occurs: the blast theory and the permeability defect theory. There is evidence for both theories, and NPE is probably the result of a combination of the two. The treatment is mainly supportive with the use of mechanical ventilation and alpha-adrenergic blocking agents while managing increased intracranial pressure. A thorough understanding of the pathophysiological mechanisms behind the development of NPE aids in the management of these patients to prevent further complications.
authors.affiliation: Merck & Co, Inc.
authors.forename: A M
authors.initials: AM
authors.lastname: Pyeron
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009730:Nursing Assessment; D010347:Patient Care Planning; D011182:Postoperative Care; D011654:Pulmonary Edema / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
chemical_list: D000317:Adrenergic alpha-Antagonists