The use of 2-ethylhexanol in acute pulmonary edema.

The patient with acute pulmonary edema presents a picture of impending disaster. An agent with an effective antifoaming action might prove a valuable adjunct to accepted therapeutic measures. Survival during the initial critical period would be enhanced by permitting a more effective oxygen exchange in the alveolar tissues since a large amount of fluid in the respiratory passages can be tolerated as long as no foam is formed.’ Factors producing pulmonary edema include high blood pressure in capillaries of the pulmonary circulation, increased permeability of these vessels, decreased osmotic pressure, and neurogenic factors. Some drugs may be useful for one form of edema and may be contraindicated for another. For example, intravenous strophanthin may cause ectopic rhythms if given for this dire complication of coronary occlusion.2 Venesection, spinal anesthesia,3 merucrial diurectics,4 and possibly morphine5 may further reduce venous return and cardiac output during some shock states. Positive pressure oxygen is given during expiration and may be harmful in the presence of surgical shock or pulmonary emphysema.67 Morphine, barbiturates and chloral are useful in cardiac patients but may exert a depressing action on the nerve centers when employed for edema owing to central nervous system injuries or inflammations. Hence, a therapeutic agent which could be employed in any case of acute pulmonary edema, regardless of the etiology, would be a useful adjunct. Recent experimental and clinical studies by Luisada have demonstrated that certain volatile substances decrease the foaming. He has employed ethyl alcohol in his work which has been substantiated by other investigators.9