MANAGEMENT OF ACUTE PULMONARY EDEMA WITH NON-INVASIVE

VENTILATION IN PATIENT WITH PREECLAMPSIA 2 DAYS AFTER C-SECTION

Ahmad Angga Luthfi*, Zulkifli**

*Resident, Department of Anesthesiology and Intensive Care, Faculty of Medicine Sriwijaya

University, Dr. Moh. Hoesin Hospital Palembang, Indonesia
**Intensivist Consultant, Department of Anesthesiology and Intensive Care, Faculty of Medicine
Sriwijaya University, Dr. Moh. Hoesin Hospital Palembang, Indonesia

Introduction

Non-invasive ventilation (NIV) is the delivery of assisted mechanical ventilation to the

lungs without the need of an invasive endotracheal airway. Pulmonary edema rarely
occurs in normal pregnancy but it is significant cause of maternal and perinatal morbidity
and mortality.

Case Report

A 35-year-old woman with preeclampsia 2 days after a C-section was consulted from the
room accompanied by hypertension, cough, tachypnea, and tachycardia with clinical
findings showing acute pulmonary edema. The patient is then applied non-invasive
ventilation with 8 cm H2O CPAP together with anti-hypertension and diuretic
administration. Within the next 2 days, serial blood gas analysis showed improvement in
Pa02, hemodynamically stable, and the patient was gradually weaned from the ventilator
and discarded on the 3rd day after being treated in the intensive care unit.

Discussion

The goals of management in acute pulmonary edema are to maintain adequate

oxygenation and ventilation, decrease left ventricle preload and fluid restriction. The
methods of oxygen delivery in pulmonary edema include the use of a face mask,
noninvasive ventilation and intubation with mechanical ventilation. Any kind of method
which is used depends on the presence of hypoxemia, acidosis and patient's level of
consciousness.
Conclusion

The use of NIV in acute pulmonary edema can be an option. It significantly decreases the
need of endotracheal intubation, thus improving the survival rate of patient.

References

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