July 1, 1974

Pulmonary Edema During Fluid Infusion in the Absence of Heart Failure

Author Affiliations

From the Shock Research Unit and the Department of Medicine, University of Southern California School of Medicine, the Los Angeles County-USC Medical Center, and the Center for the Critically III, Hollywood Presbyterian Medical Center, Los Angeles.

JAMA. 1974;229(1):65-68. doi:10.1001/jama.1974.03230390041023

Six critically ill patients with clinical and hemodynamic signs of hypovolemia developed roentgenographic evidence of pulmonary edema (PE) without cardiac enlargement after infusion of an average of 6.4 liters of crystalloids.

Left ventricular filling pressures remained normal. However, colloid osmotic pressure (COP) decreased to 15 torr, substantially lower than the normal of 25 torr. The low COP may account for the development of PE in the absence of pulmonary hypertension occurring singly or concurrently with changes in interstitial pressure or capillary permeability.

(JAMA 229:65-68, 1974)