Neurogenic pulmonary edema (NPE) is a potential complication of a central nervous system (CNS) insult such as intracranial hemorrhage, uncontrolled generalized seizures, head trauma, tumors, and neurosurgical procedures. The proposed etiology is massive sympathetic discharge following a CNS event. The pathogenesis is not completely understood. However, there are two theories on how NPE occurs: the blast theory and the permeability defect theory. There is evidence for both theories, and NPE is probably the result of a combination of the two. The treatment is mainly supportive with the use of mechanical ventilation and alphaadrenergic blocking agents while managing increased intracranial pressure. A thorough understanding of the pathophysiological mechanisms behind the development of NPE aids in the management of these patients to prevent further complications.
Questions or comments about this article may be directed to: Ann M. Pyeron, MSN CRNP CCRN CNRN, 11 Crabapple Place, Newtown, PA 18940. She is the associate medical program coordinator at Merck & Co., Inc., and an ICU staff nurse at InteliStaff Nursing.
© 2001 American Association of Neuroscience Nurses