Consequences of water in the lungs | Water in the lungs

Consequences of water in the lungs

The course of pneumonia can vary depending on age, immune defence status, type of pathogen and the therapy used. Young and previously healthy individuals are expected to be cured after about four to six weeks. However, old and health-limited people have the possibility of a longer course of the disease or a slower recovery.

Bronchiectasis (dilatation of the pulmonary alveoli) and pulmonary fibrosis (scarring of the lung tissue) can occur, especially in chronic cases. Further complications in the context of pneumonia are also possible. For example, pus (so-called pleural empyema) or fluid (so-called pleural effusion) can accumulate in the pleural gap, the space between the lung membrane covering the lungs and the pleura.If this results in a severe restriction of breathing, a doctor can remove fluid through a puncture and thus lead to an improvement in breathing difficulties.

In the worst case, pneumonia could also spread in the bloodstream and develop into so-called sepsis (blood poisoning). In this case, the pathogens can affect other organs such as the heart or kidneys, which can lead to their loss of function and ultimately be fatal. As a result of water retention in the lungs due to heart or kidney weakness, severe respiratory distress can occur when a pulmonary oedema develops.

In very severe cases, the mucous membranes, the nose and the tips of the fingers and toes become blue because the lungs can no longer supply the tissue with sufficient oxygen. Pleural empyema is also a consequence of water in the lungs and describes an accumulation of pus in the lung area. It is therefore advisable to also deal with this topic: Pleural empyema – what is behind it?

In order to diagnose water in the lungs or pulmonary edema, an adequate anamnesis is necessary, i.e. a conversation with the patient to take the symptoms and find possible causes. Then a clinical examination is necessary. During this examination, the patient’s general picture is assessed to see whether there are any external signs such as paleness or bluish discolored lips or fingers (signs of cyanosis, i.e. lack of oxygen).

Likewise, the examiner already pays attention to the patient’s breathing, whether he/she breathes more intensively, uses the respiratory muscles (for example, sitting upright with arms supported), coughs, or if breath sounds and faster breathing can already be heard without a stethoscope. This is followed by percussion and auscultation, during which the lungs are examined more closely. During auscultation, special attention is paid to the so-called gulling, a moist rattle sound, which occurs as a secondary sound in addition to the normal breathing sound and is heard mainly in the lower sections of the lungs.

Also the tapping (percussion) of the lung often indicates water in the lung. To confirm the diagnosis, an X-ray is often taken. On this the examiner can identify typical changes depending on the severity and extent of the pulmonary edema.

If underlying heart diseases are to be examined, an ECG (electrocardiogram) or a heart ultrasound (echocardiography) can be performed. To determine the severity of the respiratory distress, a blood gas analysis with blood from the earlobe or wrist can be performed. The oxygen and carbon dioxide content of the blood is measured. Of course, it should be noted that in an emergency, i.e. when the pulmonary edema is very acute, the diagnosis must be made more quickly in order to initiate the right measures more quickly. This may then eliminate the need for lengthy examinations such as a detailed and lengthy anamnesis.