Noncardiac pulmonary edema, newer environmental aspects. An update.

Accidental spread of potentially toxic gases, fumes, and particulate chemicals has been reported recently in various cities throughout the country and appears to be on the increase throughout the world in the past few years. Moreover, cerebral trauma, septic shock (ARDS), and environmental pulmonary edema from drug intoxication have been commonly encountered. Newer modalities of treatment include selective [corrected] fiber optic bronchoscopy, constant positive airway pressure mask, administration of surfactant, pentoxifylline, and use of newer experimental agents such as nitrous oxide, antitumor necrosis factor (ATNF), and extracorporeal carbon dioxide with low-frequency positive pressure (ECCO2R-LFPPV). The future holds promise for probable reductions in both morbidity and mortality rates of this ubiquitous occupational and environmental health problem, which is of global importance.

Pulmonary edema of environmental origin--newer concepts.

Pulmonary edema of non-cardiac origin is usually an urgent clinical problem, which has recently increased in frequency throughout the world in the past few years. This is partly due to sociological factors and to pre-eminent advances in industrial technology. Recent severe massive toxic gas explosions have had national and worldwide implications. Therefore, urgent and appropriate therapy is of utmost importance in most of these patients. The use of high flow oxygen with Constant Positive Pressure Breathing are the main inhalational therapeutic approaches. Newer modalities of treatment include: (1) earlier Fiberoptic bronchoscopy in those individuals afflicted with aspiration problems and (2) certain specific chemical blocking agents for the management of phosgene intoxication and hydrogen sulfide toxicity. Preventive environmental measures are also important.