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Neurogenic Pulmonary EdemaPhentolamine for Neurogenic Pulmonary Edema: Successful Treatment With IV Phentolamine

Danielle L. Davison, MD; Lakhmir S. Chawla, MD; Leelie Selassie, MD; Rahul Tevar, MD; Christopher Junker, MD; Michael G. Seneff, MD, FCCP
Author and Funding Information

From the Department of Critical Care Medicine and Anesthesiology, and the Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington, DC.

Correspondence to: Lakhmir S. Chawla, MD, Department of Anesthesiology and Critical Care Medicine, The George Washington University Medical Center, 900 23rd St NW, Rm G-105, Washington, DC, 20037; e-mail: lchawla@mfa.gwu.edu


Funding/Support: Financial support was provided by the Department of Anesthesiology and Critical Care Medicine at the George Washington University Medical Center.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(3):793-795. doi:10.1378/chest.11-0789
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Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant CNS insult. The cause is believed to be a surge of catecholamines that results in cardiopulmonary dysfunction. Although there are myriad case reports describing CNS events that are associated with this syndrome, few studies have identified specific treatment modalities. We present a case of NPE caused by an intracranial hemorrhage from a ruptured arteriovenous malformation. We uniquely document a rise and fall of serum catecholamine levels correlating with disease activity and a dramatic clinical response to IV phentolamine.

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