Fluid in the Lungs – Causes and Treatment

Fluid in the lungs is a broad term to describe two possible states that can give characteristic symptoms, such as a bubbling noise in the lungs (rattling) when breathing. Fluid accumulation may be in the lungs (pulmonary edema) or outside the lungs (pleural effusion), in the space between the lungs and the chest wall. The term fluid in the lungs is also used in the lungs to refer to mucus. Mucus or phlegm is really a thick, sticky secretion even though lung water is a thin fluid. Other fluid accumulation can be the result of blood or pus.

The lungs enter the thorax (chest) and lie on either side of the heart. Air travels through the air passages that surround the nose, throat (neck), trachea (trachea) and bronchi. The lung tissue is made up of small air sacs, known as alveoli, which is thin and surrounded by blood capillaries. The structure of the respiratory system allows an exchange of gases, so that essential oxygen is taken into the body and waste products, along with gases, are excreted by the exhaled air. The lung is enclosed in an airtight pleural cavity, with a small pleural space separating the lungs from the chest wall. This cavity is lined by the pleural lining, which also creates a small pleural fluid to reduce the friction between the chest wall and lungs while breathing.

Fluid in the lungs

The most common cause of fluid in the lungs is mucus or mucous produced by the lining of the airways. The airway is lined with a mucous membrane that produces a specialized tissue that produces smucus. This mucus lubricates the lining, which can dry out due to the movement of air and out of the channels as well as stopping dust or microorganisms in the air. However, under certain conditions, the mucous membranes of the respiratory tract can generate excessive amounts of mucus and this can slowly sink down the air ducts until it settles in the lungs. The cough reflex or even spontaneous coughing will usually expel most mucus through the mouth (sputum), but in cases of excessive mucus production, obstructive airway disease or diminished cough, the build up of mucus will quickly settle in the lungs.

Lung water or water in the lungs usually results from the interstitial fluid or blood plasma and may be an indication of a serious underlying condition, usually cardiovascular disease. This fluid in the lungs is known as pulmonary edema and may be accompanied by shortness of breath or shortness of breath (dyspnoea), a feeling of suffocation, anxiety and restlessness. Abnormal breathing sounds are also present, especially crackling. Pulmonary edema could be considered a medical emergency and really immediate medical intervention is necessary.

Blood can also fill in the lungs, but this usually happens as a result of severe trauma and the cause is evident, as in a shot or puncture wound. In most trauma cases, where blood can fill the lungs, the lungs collapse and the blood in the lungs collects in the chest cavity (hematothorax). Infections such as tuberculosis (TB) or lung cancer can also lead to blood accumulation in the lungs. Depending on the severity of the trauma, blood in the lungs will cause drowning and requires immediate medical attention. Pus can also occur in the lungs due to a lung abscess and also requires immediate urgent medical attention.

Causes of the fluid inside the lung
    • Bronchitis is the most common cause of mucus in the lungs and is often characterized by persistent cough. This respiratory disease can develop after the common cold or flu (seasonal influenza). often as a result of a secondary bacterial infection, but may also be more chronic and non-infectious as in the case of smokers.
    • Infections may cause hypersecretion of mucus in the respiratory tract and / or pulmonary edema and this includes viral (eg H1N1 swine flu, SARS severe acute respiratory distress syndrome), bacteria (eg tuberculosis, streptococci or pneumococcal pneumonia), fungi (eg histoplasmosis, aspergillosis, candidiasis) and parasitic (example toxoplasmosis) infectious agents.
    • Pneumonia can also cause lung water or fluid with a thinner viscosity. This can only occur on the affected lung lobe due to inflammation of the lung tissue. Pneumonia is not only caused by infection, but may be due to gastric contents being aspirated from the stomach into the lungs.
    • Allergy symptoms typically lead to increased mucus production, however, in specific acute cases there might be pulmonary edema. Retronasal can often cause phlegm collection in the lungs and allergies can cause inflammation of the bronchi and mucus in the chest of the asthmatic.
    • Near drowning results in fluid in the lungs and even if all the fluid is drained from the lungs, it is important to monitor the patient in the hospital to prevent dry drowning.
    • Many cardiovascular conditions may cause pulmonary edema, including hypertension (high blood pressure), myocardial infarction (heart attack), valvular heart disease or cardiomyopathy (damaged heart muscle).
    • Hypoalbuminemia can be caused by kidney failure, liver disease, malnutrition or protein enteropathy.
    • Kidney failure pulmonary edema, as the kidneys may not be able to filter out toxins in the blood.
    • Smoke inhalation can cause severe inflammation of the lung tissue, which leads to fluid accumulation in the lungs.
    • Lymphatic insufficiency lead to inadequate drainage of lymphatic fluid.
    • Side effects of drugs in a pulmonary edema may result and this includes OTC (over-the-counter) or prescription drugs. Narcotics or anesthetics. This may also occur after the application of the drug, when the effect of the drug appear to have worn out.
    • Inhalation, Ingestion or Injection Toxins or toxins may increase the permeability of the vessel walls, resulting in pulmonary edema. Some toxins can also increase mucus production in the lining of the lungs.
    • Autoimmune diseases such as sarcoidosis can cause fluid in the lungs due to the inflammation of the lung tissue.
    • The lack of oxygen due to high altitude can cause pulmonary edema, COPD (chronic obstructive pulmonary disease) and suffocation.

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Fluid outside the lungs

Pleural effusion is when the fluid around the lungs accumulates in the pleural space. Blood (hematothorax), fatty lymph fluid (chylothorax) or pus (empyema) can also fill the pleural space, although this occurs less frequently. Any fluid accumulation in the lungs should be taken seriously and require immediate medical attention. The fluid accumulation in the lungs compressing the lungs and this prevents normal breathing, which results in inadequate gas exchange. The types and causes of pleural effusions are discussed extensively with fluid in the lungs.

Some causes of fluid around the lung

    • Congestive heart failure is probably the most typical brings about of pleural effusion. This fluid is thicker (transudative) due to protein that is forced out of the blood vessels and into the pleural space.
    • Exudative effusion is an aqueous fluid accumulation due to inflammation caused by lung cancer such as pleural mesothelioma infections such as TB or pneumonia. Lung diseases such as asbestosis or drug reactions.
    • Hematothorax may be unusual in that a result of trauma or rupture of the large blood vessels in the case of an aortic aneurysm although the latter is caused by a pleural effusion.
    • Empyema is often due to the accumulation of pus in the pleural space to a lung abscess.
    • Chylothorax is the accumulation of lymph fluid, which has a high concentration of fat, and occurs in certain cancers, such as lymphoma.
    • Some of the causes of lung fluid accumulation can also cause pleural effusion, including kidney failure and liver disease.
The diagnosis of fluid in the lungs

During physical examination, your doctor will be able to identify unusual sounds, such as bubbling or crackling (rattling) with a stethoscope on your breathing. A whistling sound (Stridor) as well as clearly audible when you exhale. Percussion is a knocking motion done against the chest wall and will help your doctor identify with areas of the lungs that might be affected. Typically fluid accumulation causes a muffled sound compared to the normal hollow sound of the air filled lungs. Based on clinical findings and other signs and symptoms, your doctor may request further diagnostic tests that may include the following steps.

    • X-ray of the thorax is one of the most important diagnostic examinations performed to identify the severity and region that is affected. For further imaging, a thorax CT scan or chest ultrasound can be performed.
    • Due to the frequency of cardiovascular in the lungs fluid-related disorders, your doctor may perform an ECG (electrocardiogram), ultrasound of the heart (echocardiography) and other cardiac examinations.
    • Fluid may be aspirated from the pleural cavity, known as thoracocentesis, but this has been done carefully to prevent pneumothorax (accumulation of air into the pleural cavity). A pleural fluid analysis is then performed to identify the type of exudate or any microorganisms.
    • Sputum culture may be necessary to identify the cause of the infection.
    • Number of blood tests can be requested from your doctor to check kidney and liver function, proper gas exchange and heart disease.
The treatment of fluid in the lungs

Treatment depends on the cause of the fluid in the lungs. Some of the treatment options may include:

    • Antibiotics, antiviral or antifungals may be required in the event of infection.
    • Diuretics assist with additional fluid passing, but should be used cautiously in the case of heart disease.
    • Antihistamines may require allergic reactions, and these must be continued on a chronic basis to prevent exacerbations.
    • Corticosteroids can be useful for controlling inflammation and mucus production, as in asthma, and this can be used over the long term to prevent acute attacks.
    • Chest tube with a tube may be necessary for a empyema or a therapeutic pleural function, required for a pleural effusion.
    • Antihypertensives can be given in cases of hypertension.
    • Oxygen is administered in serious cases of fluid within the lungs, in which appropriate gas exchange is impaired. While this does not immediately treat the cause of the fluid in the lungs, except in a lack of oxygen, it helps with adequate gas exchange.
    • Physiotherapy could possibly be important to help with mucus drainage.

How Does The Doctor Diagnose Pulmonary Edema?

Pulmonary Edema can be manifested by sudden onset of severe breathlessness, rattling breath and coughing attacks.

Causes: What causes pulmonary edema?

The cause of pulmonary edema is either an increase in pressure within the pulmonary vessels or an increase in the permeability of the pulmonary vascular walls. Sometimes combinations of both causes are present.

Cardiac Pulmonary Edema

When the pressure within the vessels increases, it is mostly due to heart disease. One speaks of a cardial pulmonary edema. For example, a heart attack, an inflammation of the heart muscle, a disease of the coronary vessels or too high a blood pressure in pre-existing heart failure underlying.

These diseases weaken the left ventricle. As a result, they can not pump the oxygen-rich blood provided by the lungs fast enough into the body. The blood builds up in the pulmonary vein. The congestion increases the pressure on the blood vessels. As a result, blood fluid escapes from the vessels and is forced into the lung tissue. The walls of the blood vessels work like filters and allow only the liquid to pass.

The remaining blood components, such as red blood cells or other cells, are held back. The fluid first accumulates in the interstices of the cells and can then penetrate into the interior of the alveoli. As a result, they can perform their task increasingly poorly and oxygen uptake is becoming increasingly difficult.

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Altitude Pulmonary Edema

A special feature of the pulmonary edema was the so-called high-altitude edema. It is triggered in mountain climbing at high altitude in the first two to three days by a combination of oxygen deficiency and low air pressure. The vessels contract and cause an increase in blood pressure, which overloads the left ventricle and creates a backlog.

Non-cardiac pulmonary edema

In non-cardiac pulmonary edema, the most common cause is damage to the membranes of the fine pulmonary capillaries. As a result, they lose part of their barrier function; blood fluid, together with smaller cell components, can penetrate into the tissue of the lung. The more effective the lymphatic vessels can initially remove the excess fluid, the slower the development of symptoms.

In most cases, ARDS (Acute Respiratory Distress Syndrome) is the cause of membrane damage. In this case, the lungs react to massive damage, for example from infections with viruses, inhalation of toxic gases, medication, severe burns, serious cardiovascular shock or blood poisoning. Rarely, pulmonary embolism, overdose in anesthesia, or stroke can increase membrane permeability.

“Another cause is damage to the liver and kidneys, which leads to a drop in albumin in the blood – a specific blood protein,” says K√∂hler. Due to the lack of protein, the blood fluid can not be kept in the necessary amount in the blood vessels and thus reaches the cell gap to the outside.

Diagnosis

For diagnosis, the doctor asks questions about the underlying and concomitant diseases of the heart, lungs and other organs. When listening to the lungs with the stethoscope rattling noises fall on, which sometimes are already audible with the naked ear. An x-ray examination can be used to determine whether water is actually in the lungs. Important indications for pulmonary edema include accelerated breathing, increased heart rate and blueing of the skin and mucous membranes. An ECG, echocardiography and other examinations target the underlying cause.

Therapy: How is pulmonary edema treated?

Pulmonary edema is a serious, potentially life-threatening condition requiring intensive medical treatment. Patients should be transported to the hospital as soon as possible. As a first measure, an upper body and lower legs are helpful. As a result, the blood flows back to the heart slower, so this is relieved.

Breathing can be assisted by the delivery of oxygen via a nasogastric tube or a mask. In an advanced stage, positive pressure ventilation, in some cases artificial respiration is necessary. Most patients are supplied with painkillers and tranquillizers.

Dehydrating medications (diuretics) ensure that the water drains from the tissue. This not only improves the oxygen exchange at the alveoli, but also relieves the blood pressure by reducing the volume of fluid and thus reduces the burden on the heart. Drugs that dilate the vessels lower the pressure on the heart, improving the oxygen supply.

All other measures depend on the underlying cause. In case of height elevation edema sufferers should descend as soon as possible. In addition, oxygen delivery, vasodilating drugs, and positive pressure ventilation may help.