Negative pressure pulmonary edema due to upper airway obstruction in an adult patient (A case report) Erişkinde üst hava yolu obstrüksiyonu sonrasi gelişen negatif basinçli pulmoner ödem


TÜRKER Y. G. , Sayan E., YAVAŞCAOĞLU B., Kutlay O.

Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi, vol.32, no.3, pp.234-238, 2004 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 3
  • Publication Date: 2004
  • Journal Name: Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi
  • Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.234-238
  • Keywords: Airway obstruction, Laryngospasm, Pulmonary edema
  • Bursa Uludag University Affiliated: Yes

Abstract

We present a case of pulmonary edema following acute upper airway obstruction in an adult patient. This form of acute pulmonary edema appears to be related to markedly negative intrathoracic pressure due to forced inspiration against an obstructed upper airway. A 56-year-old healthy woman was scheduled for elective laparoscopic cholecystectomy under general anesthesia. Following extubation, the patient developed upper airway obstruction secondary to laryngospasm and/or laryngeal edema, which might have been triggered by the removal of the endotracheal tube with its cuff still inflated. The patient suddenly developed dyspnea, tachypnea, and hypoxemia and expectorated pink frothy secretions after relief of airway obstruction. Chest radiography revealed vascular pedicle enlargement with bilateral alveolar and interstitial infiltrates. Clinical findings and chest radiograph improved after 4hr of intermittent continuous positive airway pressure (CPAP) therapy with 10 cmH 2O, FiO2 1.0. Negative pressure pulmonary edema usually resolves rapidly with noninvasive mechanical ventilation. If the negative pressure pulmonary edema is mild aggressive diagnostic and therapeutic interventions should be avoided. The principal goals for management are early diagnosis and provision of adequate arterial oxygenation by the maintenance of airway.