Acute Pulmonary Oedema: the ins and outs

Prehospital Researcher

Acute Pulmonary Oedema


Acute pulmonary oedema (APO) is the sudden accumulation of extravascular fluid, in particular plasma, in lung tissue and alveoli that will eventually compromise gas exchange. APO is caused most commonly by congestive cardiac failure (CCF) or left ventricular failure (1, 2). This is more commonly known as cardiogenic APO.

Cardiogenic APO

Cardiogenic APO is a clinical manifestation of a downward spiral of decreasing cardiac output and increasing systemic vascular resistance in the face of underlying cardiac dysfunction. Essentially, the left ventricle is unable to effectively eject blood from the ventricle and this causes an increase in the pressure inside the pulmonary veins and capillaries. As pulmonary hydrostatic pressure increases, the plasma portion of the blood is forced into the alveoli (3). Initially, the excess fluid is picked up by lymphatic vessels and removed from the lung. Once the flow into the…

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