(1) Treatment principles: ① Reduce left atrial pressure and/or left ventricular filling pressure ② Increase left ventricular stroke volume ③ Reduce circulating blood volume ④ Reduce alveolar fluid infiltration ⑤ Ensure gas exchange.
(2) Specific measures: ① Position: Take a sitting or semi-sitting position with the legs hanging down to reduce venous return. If necessary, the limbs can be ligated in turn to further reduce blood return. ②Correction of hypoxia: Increase oxygen supply to myocardium and other organs. First, oxygen should be inhaled at 4 to 6 liters/minute. In order to reduce the impact of the large amount of foam produced by edema fluid in the airway on ventilation and diffusion, a defoaming agent (such as 30% alcohol) can be added to the humidification bottle to promote the collapse of the foam. ③Sedation: For patients with acute left heart failure, difficulty breathing, mental stress, and irritability not only increase oxygen consumption, but also increase the burden on the heart, seriously affecting treatment. It is very important to use sedatives in a timely and correct manner. ④ Diuretics: The vasodilation and diuretic effects can quickly reduce blood volume and reduce cardiac preload, which is beneficial to the relief of pulmonary edema. ⑤ Aminophylline: It can relieve bronchospasm, enhance myocardial contractility, and expand peripheral blood vessels. It can be used even when bronchial asthma and cardiac asthma cannot be distinguished. ⑥Vasodilators: can reduce the preload and afterload of the heart. ⑦ Cardiotonic agents: divided into digitalis and non-digitis types. ⑧Glucocorticoids: can reduce capillary permeability, reduce exudation, expand peripheral blood vessels, relieve bronchospasm, stabilize cell lysosomes and mitochondria, reduce the pathological response of cells and the body to stimulation and damage, and treat acute pulmonary edema. The treatment has certain value. ⑨Remove the causes and predisposing factors. ⑩ Assisted circulation: intra-aortic balloon counterpulsation or pacemaker.