Neurogenic Pulmonary Edema

Objective: Neurogenic pulmonary edema is an underrecognized and underdiagnosed form of pulmonary compromise that complicates acute neurologic illness and is not explained by cardiovascular or pulmonary pathology. This review aims to provide a concise overview on pathophysiology, epidemiology, clinical characteristics, impact on outcome and treatment of neurogenic pulmonary edema, and considerations for organ donation. Data Sources: Database searches and a review of the relevant medical literature. Study Selection: Selected studies included English-language articles concerning neurogenic pulmonary edema using the search terms neurogenic with pulmonary oedema or pulmonary edema, experimental neurogenic pulmonary edema, donor brain death, and donor lung injury. Data Extraction: Selected studies were reviewed by both authors, and data extracted based on author consensus regarding relevance for this review. Data Synthesis: Existing evidence is organized to address: 1) pathophysiology, 2) epidemiology and association with different neurologic diseases, 3) clinical presentation, 4) impact on outcome, 5) treatment, and 6) implications for organ donation after brain death. Conclusions: Neurogenic pulmonary edema occurs as a complication of acute neurologic illness and may mimic acute lung injury of other etiology. Its presence is important to recognize in patients due to its impact on clinical course, prognosis, and treatment strategies.