Pulmonary Edema Treatment: 3 Main Therapies

Pulmonary edema treatment may include oxygen therapy to improve oxygen levels in the body. Medications, such as furosemide or nitroglycerin, may also be used to help reduce fluid in the lungs.

In most cases, pulmonary edema is caused by an untreated heart problem, such as heart failure. However, nervous system changes or lung infections can also cause fluid to build up in the lungs.

Pulmonary edema treatment should be started in the hospital, as it is a medical emergency that can be life-threatening. Treatment is typically directed by the emergency care team and may involve a cardiologist, pulmonologist, or other specialists, depending on the underlying cause.

Main treatments

The main treatments for pulmonary edema are:

1. Oxygen therapy

Because the lungs are filled with fluid and cannot absorb enough oxygen, oxygen therapy is one of the first treatments for pulmonary edema. This involves breathing in oxygen through a nasal cannula or face mask.

The goal of this treatment is to keep oxygen levels in the body stable, move fluid from the lungs back into the blood vessels, reduce carbon dioxide levels in the blood, and reverse respiratory acidosis.

2. Medications

After starting oxygen therapy, other medications may be administered, such as:

• Diuretics, such as furosemide, given through a vein to reduce the amount of fluid in the lungs

• Vasodilators, such as nitroglycerin, to control blood pressure and reduce pulmonary congestion

• Calcium channel blockers, such as nifedipine, to help reduce pulmonary artery pressure and improve gas exchange in cases of pulmonary edema caused by high altitude

• Inotropes, such as dobutamine or dopamine, to reduce pulmonary congestion when it is linked to low blood pressure and reduced oxygen delivery to tissues

• Opioids, such as morphine, which have a strong pain-relieving effect and may be used in cases of pulmonary edema linked to coronary syndrome

Pulmonary edema is a medical emergency that requires immediate hospital care, so medications are usually started in the hospital.

3. Physical therapy

After recovering from pulmonary edema, the lungs may not expand as well as before, which can make it harder for them to hold larger amounts of air.

A pulmonologist may therefore recommend respiratory physical therapy sessions to improve lung capacity and strengthen the breathing muscles through exercises prescribed by a physical therapist.

These sessions may be done up to 2 times per week, for as long as needed to fully restore lung capacity.

Can pulmonary edema be cured?

Pulmonary edema can be cured if treatment is started quickly in the hospital and the cause is identified as soon as possible.

However, when treatment is delayed, pulmonary edema can worsen and lead to life-threatening complications.

Signs of improvement

The first signs of improvement usually appear within minutes to a few hours after treatment begins, including easier breathing, higher oxygen levels, reduced chest pain, and less wheezing.

When treatment is delayed, pulmonary edema can worsen. Warning signs include worsening shortness of breath, a feeling of drowning, blue-tinged hands or feet, fainting, and, in the most severe cases, respiratory arrest.

Prevention measures

Once symptoms are under control and oxygen levels are stable, the cause of fluid buildup in the lungs should be identified. This helps prevent pulmonary edema from happening again.

Depending on the cause, a healthcare provider may prescribe medicines such as:

• Vasodilators, such as nitroglycerin, which help relax blood vessels, reduce pressure on the heart, and prevent blood from backing up into the lungs
• ACE inhibitors, such as captopril, which lower blood pressure, make it easier for the heart to pump, and help prevent fluid buildup

When the cause of pulmonary edema is already known, such as in people with a history of heart problems, these medications may be started right away to help remove excess fluid more quickly. According to the American Heart Association, diuretics are commonly used in heart failure to help the body remove excess fluid and reduce fluid buildup in the lungs and other tissues.

However, if pulmonary edema symptoms appear before an underlying condition has been diagnosed, a pulmonologist may refer the person to a cardiologist or another specialist for further evaluation and treatment.