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Pulmonary Edema During Fluid Infusion in the Absence of Heart Failure

Leon Stein, MD; Jean-Jacques Beraud, MD; Jose Cavanilles, MD; Protasio da Luz, MD; Max Harry Weil, MD; Herbert Shubin, MD
JAMA. 1974;229(1):65-68. doi:10.1001/jama.1974.03230390041023.
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Six critically ill patients with clinical and hemodynamic signs of hypovolemia developed roentgenographic evidence of pulmonary edema (PE) without cardiac enlargement after infusion of an average of 6.4 liters of crystalloids.

Left ventricular filling pressures remained normal. However, colloid osmotic pressure (COP) decreased to 15 torr, substantially lower than the normal of 25 torr. The low COP may account for the development of PE in the absence of pulmonary hypertension occurring singly or concurrently with changes in interstitial pressure or capillary permeability.

(JAMA 229:65-68, 1974)


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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