Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Severe Breathlessness When Diagnosed With Crackling In Lungs?
Posted on
Tue, 26 Jan 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Mon, 25 Jan 2016
Answered on
Sat, 26 Mar 2016
Last reviewed on
Question : 69 year old, heavy smoker, quit last year. Kidney failure, dialysis 3x per week. in last 3 months, increasing impairment in oxygenation. without cannula, stat can go as low as 60-70. Renal doctor has attempted to adjust dialysis to pull more fluid. Cardiologist saying heart is functioning properly. this morning prior to dialysis, complaining of severe lack of breath. Rescue personnel arrived, blood pressure would not register, transferred to ER. vitals stableized and staff recommended transport to dialysis once crackling was discovered in lungs. Dialysis nurse called and said he had little fluid in his blood, they were only able to remove .8 liters when normal is upwards of 2.0. what is going on? We don't know where to go for answers - assuming pulmonologist?
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
In addition to my primary profession, I have also trained in renal and pulmonary medicine. I have read your query carefully. Let me give you my thoughts.
When crackling was discovered in your lungs, this normally means you had too much fluid in you which was backing up into your lungs. However, per the dialysis nurse, the amount of fluid in your circulatory system was low.
A couple of things could've happened here. First, the crackles might not have been from fluid overload, but rather from lung disease (you are a heavy smoker). This would account for the low fluid even with crackles. Second, when they stabilized your blood pressure, they have have given you medication that caused extravasation of fluid in your circulation to tissue, which means the extra fluid was not in your veins and thus not accessible to dialysis. Either way, if you are now stable, that is the good news!
Dr. Sheppe
Consultation
Detailed Answer:
Hello, and thanks for your question.
In addition to my primary profession, I have also trained in renal and pulmonary medicine. I have read your query carefully. Let me give you my thoughts.
When crackling was discovered in your lungs, this normally means you had too much fluid in you which was backing up into your lungs. However, per the dialysis nurse, the amount of fluid in your circulatory system was low.
A couple of things could've happened here. First, the crackles might not have been from fluid overload, but rather from lung disease (you are a heavy smoker). This would account for the low fluid even with crackles. Second, when they stabilized your blood pressure, they have have given you medication that caused extravasation of fluid in your circulation to tissue, which means the extra fluid was not in your veins and thus not accessible to dialysis. Either way, if you are now stable, that is the good news!
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
