Hi welcome back to our video
series in the respiratory system.
Now in this, we're gonna look at
something very serious - pulmonary edema.
Okay so let's start with, what is edema?
Now I know you're familiar with that term but have you ever
really stopped to think and break down what really it is?
So pause the video for just a second,
write some quick notes I promise it will pay off.
Wake your brain if we're moving in this topic.
Okay, hopefully you came up with some answers
but now let's kind of break it down a little more.
Edema in general means "swelling",
so if you got that, points for you.
so when you think about
edema, you think about swelling.
Now usually, we think about patients whom we see like
their legs are swollen, their feet are swollen,
that's generally a very common place to see edema.
But I want you to go down even deeper and think
about what is going on in your patient's body.
See, edema is usually caused because
fluid from inside the blood vessels
seeps outside the blood vessels and
into the surrounding tissue.
So edema, is fluid in inappropriate places
because the fluid from inside the blood vessels
has seeped outside the blood
vessels in the surrounding
That's what edema is.
Now, in your legs it's not that big a deal
but it does depend on what else is going on.
Edema is never a good thing but it
can be really serious in certain tissues.
So take what you know about edema,
right it's fluid sleeping out into tissues.
What is pulmonary edema?
Yeah, well this is the worst type of edema
because pulmonary edema affects your lungs
and affects oxygen delivery to the rest of your
So here's what's going on.
Let's take that definition of what we know about edema.
That's fluid seeping out of the blood
vessels and into the surrounding tissues.
In this case, in pulmonary edema,
the surrounding tissues are the alveoli.
They are supposed to be the air sacs of
the lungs, not the water balloons of the lungs.
Well in pulmonary edema, the alveoli
kind of become like water balloons.
You've got fluid in the alveoli and then the
alveoli can't do what they're designed to do.
Remember their job is to have those
capillaries right around them around them
so they can exchange oxygen and carbon dioxide.
So they'll pick up the carbon dioxide
that comes back from the tissues
and give oxygen so the blood can
take that out to the rest of the body.
If those alveoili are filled with fluid, remember
that excess fluid that seeped out into the tissues,
if the alveoli are filled with fluid, they're
not gonna be able to perform their job.
So edema in the lungs is the
worst case scenario for edema.
Edema in the legs - not so
fantastic but it's not as life threatening.
Pulmonary edema if it gets very severeand isn't
addressed could actually become life-threatening
because of the lack of oxygen to the brain, to
the heart into other important organs in my body.
So it's really important that you understand
what are the causes of pulmonary edema.
Well we often look to the heart because fluid volume overload
or more fluid in the patient's heart or body can handle,
that is a number one cause of pulmonary edema
Now take a look at the picture of that heart.
See the normal heart?
You've got the four chambers, got the wall separating
them cause remember your heart is a muscle.
It's supposed to be a really strong muscle but in
heart failure, a lot of times there's hypertrophy.
Now if you look at the picture of congestive heart failure,
we've shown you someone who's left ventricle looks really weird.
Well one of the common causes of congestive heart failure
is a patients heart that isn't able to pump efficiently.
So one example would be someone
who has left ventricular hypertrophy.
Now remember the job of the left ventricle is
to push blood out to the rest of the body, right?
Right atrium - right ventricle - to the lungs, gets
oxygenated - goes back to the left atrium - left ventricle,
and then out to the rest of the body.
So it's really important that
you have a strong left ventricle.
Now let's say your patient has hypertension, like
chronic hypertension and they don't treat it, right?
They don't get medical help, they
don't take their antihypertensives,
Well the heart initially says,"Woah! I really got
to work harder to push blood out of this body"
so then it says,"I know what I'll do, I'll get stronger".
So that wall gets thicker and stronger.
Well, initially that's really helpful, but over a
period of time that vessel wall gets hypertrophied.
So the left ventricle, that ventricle wall becomes
hypertrophied, it gets really thick and it becomes too thick.
So what was helpful initially, now is problematic
because it just can't function efficiently
and that's a cause of pulmonary edema.
A heart that doesn't pump efficiently is
going to have backup and problems, pulmonary edema
So I know if I have a CHF patient, I am
hyperalert watching for pulmonary edema.
I'm going to explain to you why that happy but
for now make sure you have solid in your mind
one of the causes of pulmonary
edema is overloading the heart.
You've got more fluid on board that
the patient's heart or body can handle.
Pulmonary edema is a sign of that that woah,
were way out of control with fluid-volume balance.
Now CHF is one of the ways that
your heart can't handle very much fluid
because that wall is thick or not
as effective in functioning anymore.