Pender E S, Pollack C V
Pediatric Emergency Department, University of Mississippi Medical Center, Jackson 39216-4505.
J Emerg Med. 1992 Jan-Feb;10(1):45-51. doi: 10.1016/0736-4679(92)90010-q.
Neurogenic pulmonary edema (NPE) is a relatively common though often subclinical complication of a variety of central nervous system insults (trauma, hemorrhage, seizures, etc.) in children and adults. The syndrome probably results from massive centrally mediated sympathetic discharge and generalized vasoconstriction, and often presents in the emergency department (ED). The symptoms are likely to be mistaken for aspiration pneumonia. Treatment consists of ventilatory support, including positive end-expiratory pressure, and aggressive measures to reduce intracranial pressure. We present four cases of NPE and review its recognition and emergent management.
