Recognize the risk for development of flash pulmonary edema in patients with chronic kidney disease and ESRD.
Identify causes of flash pulmonary edema that may occur in conjunction with chronic kidney disease and ESRD
Recognize signs and symptoms of flash pulmonary edema.
Flash pulmonary edema and acute pulmonary edema are terms used to define the sudden development of respiratory distress related to the rapid accumulation of fluid within the lung interstitium secondary to elevated cardiac filling pressures (Little, & Braunwald, 1997).
The risk for flash pulmonary edema in individuals with chronic kidney disease (CKD), primarily end stage renal disease (ESRD), has been under emphasized in the literature.
It may be difficult to differentiate between flash pulmonary edema and non-cardiogenic pulmonary edema since the presenting symptoms are often the same (Hanley & Welsh, 2004).
Flash pulmonary edema can originate from cardiogenic (i.e., cardiac dysfunction) and non-cardiogrenic causes (i.e., neurogenic pulmonary edema) and occurs suddenly over a period of minutes to hours (Lee, et al., 1988).
Some individuals will have evidence of both systolic and diastolic heart failure contributing to development of flash pulmonary edema. However, diastolic heart failure occurs more frequently in patients with preserved systolic function, thus it has been attributed primarily to the disorder of diastolic dysfunction (Gandhi et al., 2001).
Subgroups of patients who have recurrent episodes of congestive heart failure or flash pulmonary edema exhibit functional improvement following percutaneous transluminal renal angioplasty (PTRA) with stent placement.
Congestive heart failure and flash pulmonary edema. Patients who have recurrent episodes of congestive heart failure or flash pulmonary edema with severe RAS have marked functional improvement following PTRA with stenting.