Differentiation of noncardiogenic from cardiogenic pulmonary edema based on clinical data

Noncardiogenic	Cardiogenic
History
Underlying disease (eg, pancreatitis, sepsis)	Acute cardiac event (eg, myocardial infarction)
Physical examination
Warm periphery	Cool, mottled periphery
Bounding pulses	Small-volume pulse
Normal-sized heart	Cardiomegaly
Normal JVP	Elevated JVP
S3 absent	S3 present
No murmurs other than innocent flow murmurs	Systolic and diastolic murmurs
ECG
ECG usually normal	ECG signs of myocardial infarction/ischemia
Chest radiograph film
Peripheral infiltrates	Perihilar infiltrates
Laboratory test
BNP <100 mg/mL	BNP >100 mg/mL
Ventilatory needs
Prolonged need for ventilatory support with high FiO₂ and PEEP to oxygenate	Short duration of need for ventilatory support

JVP: jugular venous pressure; S3: third heart sound; ECG: electrocardiogram; BNP: brain natriuretic peptide; FiO₂: fraction of inspired oxygen; PEEP: positive end-expiratory pressure.

Adapted from: Sibbald WJ, Cunningham DR, Chin DN. Non-cardiac or cardiac pulmonary edema? A practical approach to clinical differentiation in critically ill patients. Chest 1983; 84:452.

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Differentiation of noncardiogenic from cardiogenic pulmonary edema based on clinical data