Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Pulmonary edema laboratory tests
Introduction
Overview
Overview
Laboratory findings consistent with the diagnosis of pulmonary edema include hypoxia, hypercapnia, acidosis. Elevated B-type natriuretic peptide (BNP) and cardiac enzyme is usually suggestive of cardiogenic pulmonary edema.
Laboratory Findings
Laboratory Findings
Laboratory findings consistent with the diagnosis of pulmonary edema include:[1][2][3]
Arterial blood gas test:
- Hypoxia:
- Oxygen saturation < 90%
- PaO2 < 60 mm Hg
- Hypercapnia:
- CO2 > 45–55 mm Hg
- Acidosis:
- PH < 7.35 nEq/liter
- Early findings of pulmonary edema may be respiratory alkalosis because of hyperventilation
Serum albumin:
- Albumin may be low in pulmonary edema
Liver function tests:
- Elevation in alanine aminotransferase, aspartate aminotransferase and bilirubin may be seen in right ventricular failure as underlying cause of cardiogenic pulmonary edema
Plasma brain natriuretic peptide levels :
- B-type natriuretic peptide (BNP) is elevated in the patient with cardiogenic pulmonary edema.
- A low BNP (<100 pg/ml) makes a cardiac cause very unlikely and is associated with non-cardiogenic pulmonary edema.
Pulmonary capillary wedge pressure(PCWP):
- A wedge pressure of 18 mmHg or higher is usually suggestive of cardiogenic pulmonary edema.
- A wedge pressure of less than 18 mmHg is usually suggestive of non-cardiogenic pulmonary edema.
Cardiac enzymes:
- Elevated concentration of troponin, may suggestive of damage to myocytes, as underlying cause of cardiogenic pulmonary edema.
Shunt fractions (Qs/Qt):
- Patients with non-cardiogenic pulmonary edema had greater shunt fractions(Qs/Qt) than patients with cardiogenic pulmonary edema.[4]
| Laboratory findings | Cardiac enzymes | BNP | PCWP | QS/QT | |
|---|---|---|---|---|---|
| Cardiogenic pulmonary edema | May be elevated | High | >18 mmHg | Small elevated | |
| Noncardiogenic pulmonary edema | Usually normal | Low | <18 mmHg | Large elevated |
References
References
- ↑ Ware LB, Matthay MA (December 2005). “Clinical practice. Acute pulmonary edema”. N. Engl. J. Med. 353 (26): 2788–96. doi:10.1056/NEJMcp052699. PMID 16382065.
- ↑ Sibbald WJ, Cunningham DR, Chin DN (October 1983). “Non-cardiac or cardiac pulmonary edema? A practical approach to clinical differentiation in critically ill patients”. Chest. 84 (4): 452–61. PMID 6617283.
- ↑ Murray JF (February 2011). “Pulmonary edema: pathophysiology and diagnosis”. Int. J. Tuberc. Lung Dis. 15 (2): 155–60, i. PMID 21219673.
- ↑ Siegel JH, Giovannini I, Coleman B (June 1979). “Ventilation:perfusion maldistribution secondary to the hyperdynamic cardiovascular state as the major cause of increased pulmonary shunting in human sepsis”. J Trauma. 19 (6): 432–60. PMID 448782.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]