IBCC Episode 117- SCAPE

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss sympathetic crashing acute pulmonary edema (SCAPE) versus fluid overload subacute pulmonary edema (FOSPE), highlighting the importance of differentiating between the two. They delve into the causes and pathophysiology of SCAPE, emphasizing the vicious spiral of pulmonary edema triggering a sympathetic response and vasoconstriction. The hosts differentiate SCAPE from FOSPE, noting key differences in blood pressure, volume status, and clinical presentation. They stress the importance of identifying and appropriately diagnosing SCAPE using point-of-care ultrasound and discuss common diagnostic pitfalls. The conversation covers triggers of SCAPE, including underlying conditions and acute factors, and outlines management principles, emphasizing non-invasive support, afterload reduction, and individualized volume management, while cautioning against the routine use of diuretics and beta-blockers in SCAPE patients.