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Noncardiogenic pulmonary edema

Michael M Givertz, MD
Section Editor
Stephen S Gottlieb, MD
Deputy Editor
Geraldine Finlay, MD


Pulmonary edema is due to the movement of excess fluid into the alveoli as a result of an alteration in one or more of Starling's forces. In cardiogenic pulmonary edema, a high pulmonary capillary pressure (as estimated clinically from the pulmonary artery wedge pressure) is responsible for the abnormal fluid movement [1]. (See "Pathophysiology of cardiogenic pulmonary edema" and "Evaluation of acute decompensated heart failure".)

In contrast, noncardiogenic pulmonary edema is caused by various disorders in which factors other than elevated pulmonary capillary pressure are responsible for protein and fluid accumulation in the alveoli [1]. The distinction between cardiogenic and noncardiogenic causes is not always possible, since the clinical syndrome may represent a combination of several different disorders. The diagnosis is important, however, because treatment varies considerably depending upon the underlying pathophysiologic mechanisms.


Fluid balance between the interstitium and vascular bed in the lung, as in other microcirculations, is determined by the Starling relationship, which predicts the net flow of liquid across a membrane. This can be expressed in the following equation:

Net filtration  =  (Lp x S)   x   (delta hydraulic pressure  -  delta oncotic pressure)

=   (Lp x S)   x   [(Pcap   -   Pif)   -  s(πcap   -   πif)]

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Literature review current through: Sep 2017. | This topic last updated: Aug 01, 2017.
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