title: Neurogenic pulmonary edema after severe head injury: a transpulmonary thermodilution study.
abstract: Neurogenic pulmonary edema (NPE) is a possible complication of severe central nervous system insult. Its physiopathology is still debated. We report a fatal case of a 55-year-old man who was admitted because of severe head injury. The diagnosis of NPE was considered according to clinical and radiologic findings. Transpulmonary thermodilution study showed decreased stroke volume index and cardiac function index. Indexed extravascular lung water was increased as well as pulmonary vascular permeability index. The impairment of the left ventricular function was confirmed by the echocardiographic study. Our case suggests that NPE imply both cardiac dysfunction and lung injury. Thus, transpulmonary thermodilution can be helpful in managing fluid balance and the choice of vasopressors in patients with life-threatening NPE.
authors.affiliation: Department of Intensive Care, Faculty of Medicine, Sfax, Tunisia. Electronic address: anischaari2004@yahoo.fr.
authors.forename: Anis
authors.initials: A
authors.lastname: Chaari
authors.affiliation: Department of Intensive Care, Faculty of Medicine, Sfax, Tunisia.
authors.forename: Kamilia
authors.initials: K
authors.lastname: Chtara
authors.affiliation: Department of radiology, Faculty of Medicine, Sfax, Tunisia.
authors.forename: Nozha
authors.initials: N
authors.lastname: Toumi
authors.affiliation: Department of Intensive Care, Faculty of Medicine, Sfax, Tunisia.
authors.forename: Mabrouk
authors.initials: M
authors.lastname: Bahloul
authors.affiliation: Department of Intensive Care, Faculty of Medicine, Sfax, Tunisia.
authors.forename: Mounir
authors.initials: M
authors.lastname: Bouaziz
mesh_terms: D006259:Craniocerebral Trauma / Q000150:complications* / Q000601:surgery; D003952:Diagnostic Imaging; D015633:Extravascular Lung Water; D017809:Fatal Outcome; D015600:Glasgow Coma Scale; D006406:Hematoma / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000175:diagnosis* / Q000209:etiology*; D013815:Thermodilution