EMERGENCY INTERVENTIONS AND HEMODYNAMIC SUPPORT IN THE TREATMENT OF ACUTE PULMONARY EDEMA

Abstract

Acute pulmonary edema (APE) is a critical clinical emergency characterized by fluid accumulation in the lung spaces, resulting in acute respiratory failure and impaired gas exchange. Traditionally classified as cardiogenic (due to left ventricular dysfunction) and non-cardiogenic (as in ARDS), emergency intervention requires rapid identification of the underlying etiology to define the therapeutic strategy. This article, a literature review, examines the evidence and protocols related to hemodynamic support and urgent interventions in APE. Effective management must balance tissue perfusion with the risk of fluid overload, with monitoring guided by markers such as Central Venous Pressure (CVP) and Extravascular Lung Water (EVLW), measured by transpulmonary thermodilution. Fundamental therapeutic strategies include non-invasive positive pressure ventilation (CPAP or BPAP), effective in improving gas exchange, reducing respiratory effort, and decreasing the need for orotracheal intubation. Pharmacological treatment includes the judicious use of diuretics to correct fluid accumulation, except in cases of hypovolemia. It is concluded that the success of the intervention is determined by continuous monitoring and individualized clinical management to stabilize the respiratory and hemodynamic function of the critically ill patient.