Neurogenic pulmonary edema: successful treatment with IV phentolamine

Chest. 2012 Mar;141(3):793-795. doi: 10.1378/chest.11-0789.

Abstract

Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant CNS insult. The cause is believed to be a surge of catecholamines that results in cardiopulmonary dysfunction. Although there are myriad case reports describing CNS events that are associated with this syndrome, few studies have identified specific treatment modalities. We present a case of NPE caused by an intracranial hemorrhage from a ruptured arteriovenous malformation. We uniquely document a rise and fall of serum catecholamine levels correlating with disease activity and a dramatic clinical response to IV phentolamine.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic alpha-Antagonists / administration & dosage
  • Adrenergic alpha-Antagonists / therapeutic use*
  • Catecholamines / blood
  • Humans
  • Infusions, Intravenous
  • Intracranial Hemorrhages / blood
  • Intracranial Hemorrhages / complications
  • Male
  • Middle Aged
  • Phentolamine / administration & dosage
  • Phentolamine / therapeutic use*
  • Pulmonary Edema / blood
  • Pulmonary Edema / drug therapy*
  • Pulmonary Edema / etiology
  • Treatment Outcome

Substances

  • Adrenergic alpha-Antagonists
  • Catecholamines
  • Phentolamine