Fluid lungJ81

Interstitial, subacute pulmonary edema in the hilus-near sections due to hyperhydration in renal failure (sodium and water retention) or excessive infusion therapy. The fluid lung often precedes manifest pulmonary oedema. Etio: Fluid lunging is often observed as a complication of acute and chronic renal failure. It is predominantly an interstitial pulmonary edema, which is radiologically impressive as a central edema with a bright peripheral edge zone corresponding to the image of butterfly wings. In addition, signs of heart enlargement are often detected.

The pathogenesis of fluid lunging is very complex; it is caused by hyperhydration, uremic-toxic permeability disorders of the pulmonary capillary wall, decrease in blood osmolarity due to hypoproteinemia and hypalbuminemia, and left heart failure (evidence of cardiac dilatation has been demonstrated).

Few specific early symptoms such as dyspnea, orthopnea, cough and tachycardia. Important is the absence of the typical wet rales of alveolar pulmonary edema, because the fluid is not in the alveolar space. Auscultatory nothing is heard except for an aggravated breath sound and wheezing.

Ro. thorax: butterfly-shaped, approximately symmetrical, centrally accentuated shadows of the lungs surrounded by a mantle-shaped zone of normal air content.

Increase of diuresis, fluid restriction, possibly respiration and fluid withdrawal by haemofiltration, in case of uremia immediate dialysis with volume withdrawal.