What is the role of lab studies in the evaluation of cardiogenic pulmonary edema (CPE)?

Updated: Jul 23, 2020
  • Author: Ali A Sovari, MD, FACP, FACC; Chief Editor: Gyanendra K Sharma, MD, FACC, FASE  more...
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Answer

Laboratory studies used in the evaluation of patients with cardiogenic pulmonary edema (CPE) include the following:

  • Complete blood count - The complete blood count (CBC) with differential helps in assessing for severe anemia and may suggest sepsis or infection if a markedly elevated white blood cell (WBC) count or bandemia is present

  • Serum electrolyte measurements - Patients with chronic CHF often use diuretics and are therefore predisposed to electrolyte abnormalities, especially hypokalemia and hypomagnesemia; patients with chronic renal failure are at high risk for hyperkalemia, especially when they are noncompliant with hemodialysis sessions

  • Blood urea nitrogen (BUN) and creatinine determinations - These tests help in assessing patients for renal failure and the anticipated response to diuretics; in low-output states, such as systolic dysfunction, decreased BUN and creatinine levels may be secondary to hypoperfusion of the kidneys

  • Pulse oximetry - Pulse oximetry is useful in assessing hypoxia and, therefore, the severity of CPE; it is also useful for monitoring the patient's response to supplemental oxygenation and other therapies

  • Arterial blood gas analysis - This test is more accurate than pulse oximetry for measuring oxygen saturation; the decision to start mechanical ventilation is based mainly on clinical findings, but in rare instances, arterial blood gas results are taken into account


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