Acute pulmonary edema caused by accidental aspiration of sweetened water in two cases of diabetes mellitus

We treated two cases of diabetes mellitus who developed acute pulmonary ede ma following accidental aspiration of sweetened water for emergency treatme nt, when they had fallen into hypoglycemic coma following an overdose of in jectable insulin. Although they showed hypoxemia and radiological examinati ons revealed pulmonary edema, they improved by giving only oxygen and antib iotics in a few days. The osmotic pressure of the sweetened water in each c ase was approximately 2,600 mOsm and 1,900 mOsm, We suppose that the pathog enesis of the pulmonary edema was due to the sweetened water causing water within the pulmonary vessels to permeate into the alveoli.