Pulmonary Edema of Environmental Origin

¹ State University of New York at Buffalo and research Institute of Millard Fillmore Hospital, Buffalo; St. Mary's and Memorial Hospitals, Niagara Falls

Fifty-five patients with chemical intoxication evoking pulmonary edema were seen in the past several years. In addition, environmental pulmonary edema from heroin intoxication, edema associated with cerebral trauma and that due to post-traumatic pulmonary insufficiency were also encountered. Most patients recovered. Treatment included inhalational therapy utilizing 40-60 percent oxygen with intermittent positive pressure breathing, endotracheal intubation or tracheostomy in the most severe problems. Digitalis and diuretics may be beneficial in a limited number of patients. Corticosteroids and hexamethylentetramine are effective in specific types of intoxications. Morphine sulfate and other narcotic agents are to be avoided in those patients with respiratory depression due to hydrogen sulfide, hydrogen cyanide, ozone, carbon monoxide and heroin intoxication. As previously mentioned, assisted or controlled ventilation may be of considerable benefit in the latter problem. Most of these patients should be treated in intensive care units and appropriate monitoring of the cardiopulmonary system should be implemented, since the majority of these patients are acutely ill.