Post-Diuretic Pulmonary Edema A Case Report

Abstract Background Post-diuretic pulmonary edema(PDPE)is a special type of acute pulmonary edema, results from rapid blood volume loss caused by diuretics. Inappropriate administration of diuretics and inotropic agent, which is mainstay of treatment of pulmonary edema Classically, might have been a critical mistake in PDPE.Maintaining appropriate volume status and beta receptor blockers is the key to reversing the progress of PDPE. However,this condition remains unfamiliar to the medical community, making it an underdiagnosed and underreported condition. Case representation A 71-year-old patient who initially was diagnosed to have acute respiratory distress syndrome (ADRS) in intensive care unit (ICU) but got further dyspnea after rapid volume depletion. Point of care ultrasound (POCUS) examination showed worsened pulmonary edema with inferior vena cava collapsed during inspiratory period and a small but hyperdynamic left ventricular(LV). The patient subsequently improved with fluid, beta blocker, increased sedation, and paralysis. Conclusion We first put forward the concept of post-diuretic pulmonary edema,in order to remind medical staff to pay attention to this type of pulmonary edema and understand its pathophysiological mechanism.