What causes Neurogenic Pulmonary Edema (NPE)?

The exact etiology of Neurogenic Pulmonary Edema (NPE) is not yet completely understood.

However, considering that there is almost always an increase in intracranial pressure post most neurological event, intracranial hypertension is believed to be a key contributing factor.

NPE may develop (within minutes to hours) of a neurogenic/CNS (central nervous system) insult, including the following:

• Embolism,
• Bacterial meningitis,
• Brain tumor,
• Bulbar poliomyelitis,
• Cerebral hemorrhage,
• Cervical spinal cord injury,
• Epileptic seizures,
• Traumatic Head injury, and
• Stroke.

Signs and Symptoms of Neurogenic Pulmonary Edema (NPE):

• Bibasilar crackles,
• Hemoptysis (streaks of blood in sputum),
• Hypoxemia,
• Radiographic pulmonary infiltrates (as evident in radiographs),
• Respiratory distress (Shortness of breath, Wheezing)
• spontaneous Dyspnea,
• Tachycardia, and
• Tachypnea.

Diagnosis of Neurogenic Pulmonary Edema (NPE):

Is often quite difficult to diagnose NPE because of the nonspecific nature of the above listed indicators. Therefore, it is a standard practice to suspect Neurogenic Pulmonary Edema (NPE) every time pulmonary edema occurs. Diagnosis for NPE may include Blood oxygen levels, Chest X-rays, and Echocardiogram.

Treatment for Neurogenic Pulmonary Edema (NPE):

The course of NPE treatment is usually dictated by the underlying disease. The following treatments/therapies may be considered:

• Oxygen therapy,
• Mechanical ventilation,
• Diuretic therapy,
• Swan-Ganz catheterization, and
• Alpha-adrenergic antagonists such as phentolamine (still experimental).

Prognosis for Neurogenic Pulmonary Edema, NPE Prognosis:

NPE usually resolves within 48-72 hours, and is generally well-tolerated by most patients. Prognosis entirely depends upon the underlying neurological conditions. Some patients may require long-term use of a ventilator.

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