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Treatments and drugs
By Mayo Clinic staffGiving oxygen is the first step in the treatment for pulmonary edema. You usually receive oxygen through a face mask or nasal cannula — a flexible plastic tube with two openings that deliver oxygen to each nostril. This should ease some of your symptoms. Sometimes it may be necessary to assist your breathing with a machine.
Depending on your condition and the reason for your pulmonary edema, you may also receive one or more of the following medications:
- Preload reducers. Preload reducing medications decrease the pressure caused by fluid going into your heart and lungs. Doctors commonly use nitroglycerin and diuretics, such as furosemide (Lasix), to treat pulmonary edema. Diuretics may make you urinate so much initially that you may temporarily need a urinary catheter while you're in the hospital.
- Morphine (Astramorph). This narcotic may be used to relieve shortness of breath and anxiety. But some doctors believe that the risks of morphine may outweigh the benefits and are more apt to use other, more effective drugs.
- Afterload reducers. These drugs dilate your blood vessels and take a pressure load off your heart's left ventricle. Some examples of afterload reducer medications include nitroprusside (Nitropress), enalapril (Vasotec) and captopril (Capoten).
- Blood pressure medications. If you have high blood pressure when you develop pulmonary edema, you'll be given medications to control it. On the other hand, if your blood pressure is too low, you're likely to be given drugs to raise it.
Treating high-altitude pulmonary edema (HAPE)
If you're climbing or traveling at high altitudes and experience mild symptoms of HAPE, descending a few thousand feet (about 600 to 900 meters) as quickly as you can, within reason, should relieve your symptoms. Oxygen also is helpful. When symptoms are more severe, you'll likely need help in your descent. A helicopter rescue may be necessary for the most serious cases, because HAPE can be life-threatening.
Some climbers take the prescription medication acetazolamide (Diamox) to help treat or prevent symptoms of HAPE. To prevent HAPE, acetazolamide is started as long as three days before ascent. Acetazolamide can occasionally have side effects — including tingling or burning in the hands and feet, confusion, diarrhea, nausea, loss of appetite, and hearing problems.
- O'Brien JF, et al. Pathophysiology of pulmonary edema. In: Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57 Accessed April 12, 2011.
- Givertz MM. Noncardiogenic pulmonary edema. http://www.uptodate.com/home/index.html. Accessed April 12, 2011.
- Gallagher SA, et al. High altitude pulmonary edema. http://www.uptodate.com/home/index.html. Accessed April 12, 2011.
- Heart failure. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Hf/HF_All.html. Accessed April 7, 2011.
- Cardiomyopathy. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cm/cm_all.html. Accessed April 7, 2011.
- ARDS. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_All.html. Accessed April 7, 2011.
- High blood pressure. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_All.html. Accessed April 7, 2011.
- Maggiorini M. Prevention and treatment of high-altitude pulmonary edema. Progress in Cardiovascular Diseases. 2010;52:500.
- Scherrer U, et al. New insights in the pathogenesis of high-altitude pulmonary edema. Progress in Cardiovascular Diseases. 2010;52:485.
- How the heart works. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/hhw/hhw_all.html. Accessed April 7, 2011.
- Lung function tests. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/lft/lft_all.html. Accessed April 12, 2011.
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