Pathogenesis of pulmonary edema: learning from high-altitude pulmonary edema.

Details

Serval ID
serval:BIB_D0186E41E367
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Pathogenesis of pulmonary edema: learning from high-altitude pulmonary edema.
Journal
Respiratory Physiology & Neurobiology
Author(s)
Sartori C., Allemann Y., Scherrer U.
ISSN
1569-9048
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
159
Number
3
Pages
338-349
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Abstract
Pulmonary edema is a problem of major clinical importance resulting from a persistent imbalance between forces that drive water into the airspace of the lung and the biological mechanisms for its removal. Here, we will review the fundamental mechanisms implicated in the regulation of alveolar fluid homeostasis. We will then describe the perturbations of pulmonary fluid homeostasis implicated in the pathogenesis of pulmonary edema in conditions associated with increased pulmonary capillary pressure, namely cardiogenic pulmonary edema and high-altitude pulmonary edema (HAPE), with particular emphasis on the latter that has provided important new insight into underlying mechanisms of pulmonary edema. We will provide evidence that impaired pulmonary endothelial and epithelial nitric oxide synthesis and/or bioavailability may represent a central underlying defect predisposing to exaggerated hypoxic pulmonary vasoconstriction, and, in turn, capillary stress failure and alveolar fluid flooding. We will then demonstrate that exaggerated pulmonary hypertension, while possibly a prerequisite, may not always be sufficient to cause HAPE, and how defective alveolar fluid clearance may represent a second important pathogenic mechanism. Finally, we will outline, how this new insight gained from studies in HAPE, may be translated into the management of pulmonary edema and hypoxemia related disease states in general.
Keywords
Altitude, Extracellular Fluid/metabolism, Humans, Pulmonary Alveoli/physiopathology, Pulmonary Edema/physiopathology, Water-Electrolyte Balance/physiology
Pubmed
Web of science
Create date
22/02/2008 16:02
Last modification date
20/08/2019 16:50
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