Rapin M, Lemaire F
Sem Hop. 1979;55(7-8):331-4.
Non cardiogenic pulmonary edema is caused by an increase of alveolocapillary permeability, due to different etiologies: fat embolism, multiple trauma, septic shock, influenza pneumonia, aspiration syndrome... Chest radiographs exhibit interstitial and/or alveolar pattern, severity of injury is assessed by the magnitude of intra-pulmonary shunting. Pulmonary wedge pressure is normal, and increased pulmonary vascular resistance is sometimes evidence in prolonged evolutions, especially in fatal cases. Treatment consists in the suppression of hypervolemia, and ventilation with positive and expiratory pressure (PEEP). Extra-corporeal membrane lung oxygenation remains since now rather unsuccessful.
非心源性肺水肿是由肺泡毛细血管通透性增加引起的,病因各不相同:脂肪栓塞、多发性创伤、感染性休克、流感肺炎、误吸综合征……胸部X光片显示间质和/或肺泡模式,损伤的严重程度通过肺内分流的大小来评估。肺楔压正常,在病程延长时,尤其是在致命病例中,有时会出现肺血管阻力增加的情况。治疗包括控制血容量过多,以及采用正压呼气末正压通气(PEEP)。迄今为止,体外膜肺氧合治疗效果欠佳。