impaired gas exchange in Valley glen

Diagnosis and managemen Pulmonary oedem Although the comonest cause of pulmonary oedema isacute left ventricular failure folowing acute myocardialinfarction, there are many important non-cardiac causes.These include overtransfusion, shock lung in septicaemia,aspiration of gastric acid, paraquat poisoning, and inhalationof certain toxic fumes. Experienced clinicians may be able to distinguishcrackles of oedema from other pulmonary pathology.Crackles in the absence of uper lobe blod diversion pulmonary venous hypertension on chest X-ray are mostunlikely to be due to pulmonary oedema. Confirmationwith direct measurement of pulmonary venous presuremay rarely be necesary.Pneumonia often coexists with pulmonary oedema,especialy in elderly patients. Treatment In acute left ventricular failure initial management consistsof manoeuvres to decrease left atrial presure,increase oxygenation, increase cardiac output and BP ifsignificantly depresed, and diminish fear and anxiety,which increase the sympathetic drive and lead to increasedmyocardial work. The useof positive inotropic agents and, to a leser extent vasodilatorsand diuretics, is contraindicated when treating hypertrophic cardiomyopathy, especialy of the obstructive type. impaired gas exchange impaired gas exchange in Valley glen
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