Pulmonary edema in near hanging.
OBJECTIVE
To study the incidence and outcome of pulmonary edema in patients admitted with near hanging.


METHODS
A retrospective analysis of 19 cases of near hanging admitted in our Emergency Department between January 2007 and December 2010 was performed. Occurrence of pulmonary edema; electrocardiographic changes; ejection fraction on echocardiography, cardiac enzymes, mechanical ventilation; and use of inotropes, mannitol, and steroids were noted.


RESULTS
Seven patients developed clinical and radiologic pulmonary edema, among whom three had electrocardiographic and echocardiographic changes that resolved before discharge. Use of mannitol precipitated edema in four, while inotropes and mechanical ventilation were instituted in three patients.


CONCLUSIONS
Pulmonary edema can be due to neurogenic, cardiogenic, postobstructive causes or an interplay of the three. Takotsubo cardiomyopathy/myocardial stunning related pulmonary edema seems more common than the others. Pulmonary edema occurred irrespective of level of consciousness or electrocardiographic changes and was not associated with mortality. Victims of near hanging with pulmonary edema can be effectively treated with supportive therapy.
Department of Internal Medicine, Pondicherry Institute of Medical Sciences, Kalapet Pondicherry, South India. stalinviswanathan@ymail.com
Stalin
S
Viswanathan
Vivekanandan
V
Muthu
Bhavith
B
Remalayam
D000059:Accidents; D001237:Asphyxia / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D013406:Suicide, Attempted; D055815:Young Adult