Treatments and drugs

By Mayo Clinic Staff

Giving oxygen is the first step in the treatment for pulmonary edema. You usually receive oxygen through a face mask or nasal cannula — a flexible plastic tube with two openings that deliver oxygen to each nostril. This should ease some of your symptoms. Your doctor will monitor your oxygen level closely. Sometimes it may be necessary to assist your breathing with a machine such as a mechanical ventilator.

Depending on your condition and the reason for your pulmonary edema, you may also receive one or more of the following medications:

  • Preload reducers. Preload reducing medications decrease the pressure caused by fluid going into your heart and lungs. Doctors commonly prescribe nitroglycerin and diuretics such as furosemide (Lasix) to treat pulmonary edema. Diuretics may make you urinate so much initially that you may temporarily need a urinary catheter while you're in the hospital. The drug nifedipine (Procardia) may sometimes be prescribed.
  • Morphine (Avinza, MS Contin). This narcotic may be used to relieve shortness of breath and anxiety. But some doctors believe that the risks of morphine may outweigh the benefits and are more apt to use other more-effective drugs.
  • Afterload reducers. These medications, such as nitroprusside (Nitropress), dilate your blood vessels and take a pressure load off your heart's left ventricle.
  • Blood pressure medications. If you have high blood pressure when you develop pulmonary edema, you'll be given medications to control it. Alternatively, if your blood pressure is too low, you're likely to be given medications to raise it.

If your pulmonary edema is caused by another condition such as a nervous system condition, your doctor will treat the condition that is causing it and the pulmonary edema.

Treating high-altitude pulmonary edema (HAPE)

If you're climbing or traveling at high altitudes and experience mild symptoms of HAPE, descending 2,000 to 3,000 feet (about 600 to 900 meters) as quickly as you can, within reason, should relieve your symptoms. You should also reduce physical activity and keep warm, as physical activity and cold can make your condition worse.

Oxygen is usually the first treatment and can often relieve your symptoms. If supplemental oxygen isn't available, you may use portable hyperbaric chambers, which imitate a descent for several hours until you can descend to a lower elevation.

In addition to oxygen and descending to a lower elevation, the medication nifedipine (Procardia) may help reduce pressure in the pulmonary arteries and improve your condition.

When symptoms are more severe, you'll likely need help in your descent. A helicopter rescue may be necessary for the most serious cases because HAPE can be life-threatening.

Some climbers take prescription medications such as acetazolamide (Diamox Sequels) or nifedipine to help treat or prevent symptoms of HAPE. To prevent HAPE, medication is started at least one day before ascent.

July 24, 2014