Definition
Water in the lungs describes pulmonary edema, in which there is massive leakage of fluid from the pulmonary capillaries into the alveolar space of the lungs.
Causes
In this article you will find explanations of the following causes of water in the lungs:
- Cardiac cause
- Non-cardiac causes
- Pneumonia
- Operation
- Cancer
- Metastases
Water in the lungs (pulmonary edema) can be caused by various factors. The most common underlying cause is cardiac insufficiency, which mainly affects the left ventricle (the left heart muscle). If the heart is weakened, it can no longer pump the blood properly into the circulation.
As a result, the blood from the left ventricle accumulates via the left atrium back into the pulmonary circulation. This congestion increases the pressure in the pulmonary vessels. As a result, fluid is pressed from the capillaries (the smallest lung vessels) into the interstitial tissue of the lungs (interstitium) and the alveoli, where it accumulates as water.
This is called cardiac pulmonary edema, because the heart is responsible for the accumulation of water in the lungs. The second most common cause of water in the lungs is kidney weakness (renal insufficiency). When the kidneys no longer work properly, not enough fluid is excreted from the body.
This leads to a general overhydration of the body. In this case, the blood is much thinner and contains more fluid than solid components such as protein. To compensate for this imbalance, fluid passes from the blood into the tissues.
This can lead to water retention in the legs (leg edema, “thick legs”), but also to water retention in the abdomen (ascites) or lungs (pulmonary edema). Such cases where the water in the lungs has no cause that affects the heart are called non-cardiac pulmonary edema. Non-cardiac pulmonary edema can also be caused by lung diseases or allergic reactions.
In these cases, the permeability of the pulmonary vessels is usually increased and there may be increased leakage of fluid into the interlung spaces and pulmonary alveoli. Pneumonia can often be the cause of water in the lungs, which is shown in the chest X-ray as so-called lung infiltrate. In pneumonia, fluid accumulates and inflammatory cells (leukocytes) migrate from the lung vessels into the inflamed lung tissue.
Inflammation is usually the result of an infection with a bacterial pathogen. In young people, the so-called pneumococci (spherical bacteria of the genus Streptococcus pneumoniae) are the most frequent triggers. A pneumonia manifests itself by a sudden, strong feeling of illness with a high fever, a productive cough with purulent sputum (yellowish green) and an increased respiratory rate, difficult breathing, which may also be accompanied by pain if the inflammation has also spread to the lung skin.
However, infection with other pathogens and especially in elderly patients may lead to deviating symptoms. In this so-called atypical pneumonia (pneumonia), there is a rather slow onset with a slight fever, headache and aching limbs, a dry cough and shortness of breath. Especially after major surgery, a temporary accumulation of water in the lungs can occur.
This can have several causes. Quite often, and especially after lying down for a long time during the operation, this can be an indication of a reduced conversion and is completely harmless. In most cases it is only a small amount of fluid in the lungs, which the patient does not notice.
During an operation, patients are usually ventilated, i.e. they do not breathe themselves and are given a tube inserted into the trachea. Despite safety precautions, the patient may swallow the tube unnoticed during the operation. This can then lead to pneumonia, a so-called aspiration pneumonia, which results in increasing water retention in the lungs.
Here, the patient’s symptoms are usually more severe than with the simple and uncomplicated change in the wake-up phase. Furthermore, there are severe courses in which there can be a large accumulation of water in the lungs.Especially due to a collapse of the organ system and multiorgan failure, the lungs can be flooded with water. Multi-organ failure occurs almost exclusively after long and serious operations and usually only if the patients are preloaded and have many concomitant diseases.
Elderly patients, e.g. whose kidneys are pre-damaged, who also have severe heart failure (cardiac insufficiency) and diabetes mellitus and who have to undergo heart surgery, for example, have a high risk of getting water in their lungs during and after a long operation. The reason for this is usually that in the event of multiorgan failure, the kidneys are no longer able to transport water out of the body. This water is then deposited in the hanging parts of the body and also in the lungs.
If the amount of water in the lungs increases sharply, the patient feels difficulty breathing. Immediate treatment must be started. This cause is rare and requires urgent intensive medical treatment.
Much more often after serious surgery, pneumonia occurs, which, if severe, can also lead to water ingress into the lungs. In addition to breathing difficulties, coughing can also occur. For this reason, after longer surgical interventions, especially of the heart, an x-ray of the lungs is usually taken in order to detect and treat pneumonia and water in the lungs at an early stage.
In every case of cancer, water in the lungs can occur during the course of the disease and especially as the cancer progresses and spreads. In this case, however, a distinction should be made as to where in the lungs the water collects. The term “water in the lungs” is typically used to describe pulmonary edema.
This is a clinical picture in which fluid enters the pulmonary alveoli as a result of changes in pressure in the cardiopulmonary circulation. However, the water can also accumulate in the gap between the lung and the lung membrane, a so-called pleural effusion. This is much more common in cancers, especially those of the lung.
In the course of a cancerous disease of the lung, an inflammatory reaction occurs around the cancer, which infiltrates fluid to break down the inflammatory foreign body. If large quantities of this fluid are ingested during the inflammatory reaction, it can spread through the lung or lung gap and cause severe shortness of breath. The cancer can also compress additional ingrowing lymph vessels, which normally remove pollutants, causing additional lymph fluid to accumulate in the lungs and also leading to symptoms.
Another cause for the accumulation of water in the lungs can be the mechanical obstruction of lung movement by the cancer. A large, advanced cancer prevents the lung from spreading to its normal extent. As a result, water can accumulate in areas that are no longer sufficiently developed and lead to pulmonary edema with severe breathing difficulties.
Click here for the article: Lung cancer metastases are a common and dreaded complication of almost every cancer disease. The lung is one of the organs into which a large number of tumors spread. These lung metastases then behave in a similar way to lung cancer and can lead to serious complaints in the lungs.
As with lung cancer, the presence of metastases leads to an inflammatory reaction in the surrounding tissue. This in turn leads to fluid influx and ingrowth of new lymph vessels. If the ratio of water inflow to water removal is not balanced, pulmonary edema develops and water is produced in the lungs.
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