Pulmonary oedema — the cardiogenic versus the non-cardiogenic

The cardiogenic versus the non-cardiogenic — confirm mechanism/fluid/heart/BNP/echo discriminators and cause lists against local respiratory teaching; the held review covers NIV/CPAP in cardiogenic oedema (reduced venous return and LV afterload, lower filling pressure, improved vitals/physiology, less intubation and mortality versus conventional oxygen).^[2]

The management of the cardiogenic:

1. The upright position, the high-flow oxygen — per local protocol.
2. The CPAP (or BiPAP if hypercapnic) — reduces venous return and LV afterload, improves vitals and physiology, decreases intubation and mortality versus conventional oxygen.^[2]
3. The IV GTN — confirm dose against local protocol.
4. The IV furosemide — confirm dose against local protocol.
5. The treat-the-cause (PCI, rate control, valve) — per local protocol.
6. The high-dependency or the intensive care — per local disposition protocol.

^[3]The principles: cardiogenic hydrostatic versus ARDS permeability — CPAP/NIV scope is held-review evidence^[2]; vasodilator, diuretic, cause-treatment and ventilation specifics per local protocol. Morphine scope: held systematic review found mostly unfavourable results without a focused RCT — confirm use against local protocol.^[3]