title: Neurogenic pulmonary edema: successful treatment with IV phentolamine.
abstract: Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant CNS insult. The cause is believed to be a surge of catecholamines that results in cardiopulmonary dysfunction. Although there are myriad case reports describing CNS events that are associated with this syndrome, few studies have identified specific treatment modalities. We present a case of NPE caused by an intracranial hemorrhage from a ruptured arteriovenous malformation. We uniquely document a rise and fall of serum catecholamine levels correlating with disease activity and a dramatic clinical response to IV phentolamine.
authors.affiliation: Department of Critical Care Medicine and Anesthesiology, and the Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington, DC.
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Davison
authors.affiliation: Department of Critical Care Medicine and Anesthesiology, and the Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington, DC. Electronic address: lchawla@mfa.gwu.edu.
authors.forename: Lakhmir S
authors.initials: LS
authors.lastname: Chawla
authors.affiliation: Department of Critical Care Medicine and Anesthesiology, and the Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington, DC.
authors.forename: Leelie
authors.initials: L
authors.lastname: Selassie
authors.affiliation: Department of Critical Care Medicine and Anesthesiology, and the Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington, DC.
authors.forename: Rahul
authors.initials: R
authors.lastname: Tevar
authors.affiliation: Department of Critical Care Medicine and Anesthesiology, and the Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington, DC.
authors.forename: Christopher
authors.initials: C
authors.lastname: Junker
authors.affiliation: Department of Critical Care Medicine and Anesthesiology, and the Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington, DC.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Seneff
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D002395:Catecholamines / Q000097:blood; D006801:Humans; D007262:Infusions, Intravenous; D020300:Intracranial Hemorrhages / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D010646:Phentolamine / Q000008:administration & dosage / Q000627:therapeutic use*; D011654:Pulmonary Edema / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000317:Adrenergic alpha-Antagonists; D002395:Catecholamines; D010646:Phentolamine