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Lakhmir S. Chawla, MD; Danielle L. Davison, MD; Michael G. Seneff, MD, FCCP
Author and Funding Information

From George Washington University.

Correspondence to: Lakhmir S. Chawla, MD, George Washington University, 900 23rd St, NW, Room G-105, Washington, DC 20037; e-mail: minkchawla@gmail.com


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Seneff has participated on the speakers’ bureau for Pfizer, Inc. Drs Chawla and Davison have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(3):809-810. doi:10.1378/chest.12-1031
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To the Editor:

We thank Drs Krishnamoorthy and Weinberg for their comments on our article in CHEST.1 We agree that clinical trials are the next step. Our group has proposed a pragmatic clinical definition of neurogenic pulmonary edema (NPE) that may assist investigators in developing inclusion/exclusion for such a clinical trial: (1) bilateral pulmonary infiltrates, (2) Pao2/Fio2 ratio <200, (3) no evidence of left atrial hypertension, (4) presence of CNS injury (severe enough to have significantly increased intracranial pressure), and (5) absence of other common causes of ARDS (eg, aspiration, massive blood transfusion, sepsis).2 Given the rare nature of NPE, we also suggest that an online registry using this definition would be worthwhile to assess the incidence, morbidity, and mortality of NPE.

Davison DL, Chawla LS, Selassie L, Tevar R, Junker C, Seneff MG. Neurogenic pulmonary edema: successful treatment with IV phentolamine. Chest. 2012;141(3):793-795. [PubMed] [CrossRef]
 
Davison DL, Terek M, Chawla LS. Neurogenic pulmonary edema. Crit Care. 2012;16(2):212. [PubMed] [CrossRef]
 

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Davison DL, Chawla LS, Selassie L, Tevar R, Junker C, Seneff MG. Neurogenic pulmonary edema: successful treatment with IV phentolamine. Chest. 2012;141(3):793-795. [PubMed] [CrossRef]
 
Davison DL, Terek M, Chawla LS. Neurogenic pulmonary edema. Crit Care. 2012;16(2):212. [PubMed] [CrossRef]
 
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