HEMODYNAMIC PATTERNS IN NEUROGENIC PULMON ARY-EDEMA IN CHILDREN

Acute neurogenic pulmonary edema (NPE) can dramatically complicate a s erious brain injury. From bibliographic data and four personal cases d ocumented by and haemodynamical study. the authors analyse the pathoph ysiological mechanisms and the haemodynamical changes resulting from m assive sympathic outflow, the main mechanism of NPE being haemodynamic al rather than lesional. This rare complication needs to be recognized in order to undergo an intensive care treatment generally leading to a favourable evolution. This treatment lies on circulatory and ventila tory supports with positive and expiratory pressure in order to mainta in an optimal oxygenation and an optimal cerebral perfusion pressure. With this treatment the outcome of NPE is usually favourable with comp lete recovery within 2 to 5 days.