Treatment

The first treatment for acute pulmonary edema is supplemental oxygen. You usually receive oxygen through a face mask or nasal cannula — a flexible plastic tube with two openings that deliver oxygen to each nostril. This should ease some of your symptoms.

Your doctor will monitor your oxygen level closely. Sometimes it may be necessary to assist your breathing with a machine such as a mechanical ventilator or one that provides positive airway pressure.

Depending on the severity of your condition and the reason for your pulmonary edema, you may also receive one or more of the following medications:

• Diuretics. Doctors commonly prescribe diuretics, such as furosemide (Lasix), to decrease the pressure caused by excess fluid in your heart and lungs.
• Morphine (MS Contin, Oramorph, others). This narcotic may be taken by mouth or given through an IV to relieve shortness of breath and anxiety. But some doctors believe that the risks of morphine may outweigh the benefits and are more likely to use other drugs.
• Blood pressure drugs. If you have high or low blood pressure when you develop pulmonary edema, you'll be given medications to help manage the condition. Your doctor may also prescribe medications that lower the pressure going into or out of your heart. Examples of such medicines are nitroglycerin (Nitromist, Nitrostat, others) and nitroprusside (Nitropress).
• Inotropes. This type of medication is given through an IV if you are in the hospital with severe heart failure. Inotropes improve heart pumping function and maintain blood pressure.

It is important to diagnosis and treat, if possible, any nervous system problems or causes of heart failure.

Treating high-altitude pulmonary edema (HAPE)

As with other forms of pulmonary edema, oxygen is the usually the first treatment. If supplemental oxygen isn't available, you may use portable hyperbaric chambers, which imitate a descent for several hours until you are able to move to a lower elevation.

Treatments for high-altitude pulmonary edema (HAPE) also include:

• Immediately descending to a lower elevation. If you're climbing or traveling at high altitudes and have mild symptoms of HAPE, descend 1,000 to 3,000 feet (about 300 to 1,000 meters) as quickly as you can, within reason. Depending on the severity of your condition, you may need rescue assistance to get off the mountain.
• Stop exercising and stay warm. Physical activity and cold can make pulmonary edema worse.
• Medication. Some climbers take prescription medications such as acetazolamide or nifedipine (Adalat CC, Procardia) to help treat or prevent symptoms of HAPE. To prevent HAPE, medication is started at least one day before ascent.