Management

To improve oxygenation

• Supplemental oxygenation

• Possibly, ventilatory support (invasive or noninvasive)

Maintain adequate perfusion (e.g., IV fluid therapy) to prevent end-organ damage

Treat the underlying disease

Diuretics: treatment of choice (e.g., furosemide)

Opioids (e.g., morphine)

• To reduce systemic vascular resistance (lowers blood pressure) and anxiety

• Used in pulmonary edema secondary to acute coronary syndrome

• Can cause respiratory depression and is, therefore, not generally recommended

IV nitroglycerin

• If systolic blood pressure is > 110 mm Hg

• Decreases preload and pulmonary congestion

Nesiritide: to reduce PCWP and cardiac filling pressures

Dobutamine or dopamine: to reduce pulmonary congestion in patients with low systolic blood pressure

Nifedipine: in prophylaxis and treatment of high altitude pulmonary edema

ARDS with progressive hypoxemia

Respiratory failure, requiring mechanical ventilation

Further complications depend on the underlying condition.