A case of negative pressure pulmonary edema in an asthmatic patient after laparoscopic cholecystectomy

Rasheed, Asim; Palaria, Urmila; Rani, D Devika; Sharma, Shatrunjay

doi:10.4103/0259-1162.128919

Cited by 5 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The central pathogenetic mechanism is the Muller maneuverinspiratory effort against a closed glottis. During Muller maneuvre, the intrapleural pressures decrease at -50 to -100 cmH 2 O (normal baseline -5 cmH 2 O) and will result in a sudden increase of venous return associated with increased left ventricle afterload (interventricular interdependence and increased wall tension) [7][8][9][10][11]. Increased pulmonary capillary hydrostatic pressure and decreased intraalveolar pressure will result in interstitial and alveolar edema [12,13].…”

Section: Resultsmentioning

confidence: 99%

Synthetic Phenylpiperidine Derivative Meperidine as a Trigger for Type I Negative Pressure Pulmonary Edema in General Anesthesia

Baracan¹,

Gavris²,

Poroch³

et al. 2017

Rev. Chim.

View full text Add to dashboard Cite

We present a case of type I negative pressure pulmonary edema in a healthy 17-year-old boy who underwent an emergent appendectomy under general anesthesia. The particularity of our case revolves around the administration of meperidine for perioperative shivering, along with other anesthetic risk factors, which may have served as the trigger of type I negative pressure pulmonary edema.We present the pathophysiological mechanisms, the formulation of clinical and paraclinical diagnosis and the principles of intensive care therapy. This was the first such case experienced in our practice, with a remarkable learning opportunity.Negative pressure pulmonary edema (NPPE) is an acute, potentially life threatening, uncommon perioperative pathological entity. Two clinical types have been described: type I NPPE, associated with acute airway obstruction, and type II NPPE, associated with chronic partial upper airway obstruction. An early differential diagnosis between various pulmonary edema conditions in critically ill patients and a prompt recognition of high risk of acute morbidity are crucial in certain circumstances. We present a case of type I NPPE in a healthy 17-year-old boy who underwent an emergent appendectomy under general anesthesia. The particularity of our case revolves around the administration of meperidine, along with other anesthetic risk factors, which may have served as the trigger of NPPE. Experimental part Study case presentationA 17-year-old male patient without medical history presented with acute appendicitis. After evaluation in the emergency department, he was admitted for emergency appendectomy. His preoperative physical examination and laboratory tests were within normal limits except for neutrophilic leukocytosis.Physical status: height (H) = 1.60 m; weight (W) = 50 kg; body mass index (BMI) = 19.53 kg/m 2 ; airway assessment by Mallampati classification of oral opening -Mallampati I.Cardiovascular status: blood pressure (BP) = 117/59 mmHg; heart rate (HR) = 75 bpm; heart auscultationnormal.Respiratory status: chest auscultation was clear bilaterally, without murmurs. His baseline pulse oximetry arterial blood oxygen saturation (SpO 2 ) was 99% on room air, with a fraction of inspired oxygen (FiO 2 ) of 0.21. * email: claudiagavris@yahoo.com, Phone: +40723791322; vlader2000@yahoo.com, Phone: +40723271972 Laboratory blood investigations: hemoglobin (Hgb) = 15.2 g/L; hematocrit (Hct) = 42%; leukocytes (L) = 9,450/ µL (neutrophils = 90%); platelets (PLT) = 221,000/µL; activated partial prothrombine time (aPTT) = 24.4 s; international normalized ratio (INR) = 1.09; serum proteins = 71 g/L; fibrinogen = 3.22 g/L; C-reactive protein (CRP) = 11.3 mg/L; glycemia = 110 mg/dL; serum Na + = 135 mmol/L; serum K + = 4.1 mmol/L; serum Cl -= 98,5 mmol/ L; serum total calcium = 9.43 mg/dL; serum Mg + = 1.81 mg/dL; aspartate aminotrasferase (AST) = 20 U/L; alanine aminotransferase (ALT) = 18 U/L; lactate dehidrogenase (LDH) = 374 U/L; blood urea nitrogen (BUN) = 33.3 mg/ dL; creatinine = 1.06 mg/dL.The patient w...

show abstract

Section: Resultsmentioning

confidence: 99%

Synthetic Phenylpiperidine Derivative Meperidine as a Trigger for Type I Negative Pressure Pulmonary Edema in General Anesthesia

Baracan¹,

Gavris²,

Poroch³

et al. 2017

Rev. Chim.

View full text Add to dashboard Cite

show abstract

“…Obstruction of the airway, which is caused by a closed glottis, contracted pharynx, and attachment of the tongue to the palate during swallowing, contributes to creating a strong negative pressure in the thoracic cavity through inspiratory effort. Intrathoracic pressure may decrease, ranging from − 50 to -100 cmH 2 O, when inspiration is attempted against a closed glottis [17].…”

Section: Discussionmentioning

confidence: 99%

Mastering Vacuum Swallowing to Improve Pharyngeal Bolus Passage by Creating Negative Pressure in the Esophagus

Kunieda

Fujishima²,

Ohno³

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective Vacuum swallowing improves pharyngeal bolus passage by creating negative pressure in the esophagus. This study aimed to (1) assess whether patients with dysphagia with lateral medullary syndrome (LMS) could reproduce vacuum swallowing and (2) evaluate its safety using a swallowing and breathing monitoring system (SBMS). Methods Two patients with dysphagia with LMS were instructed to perform vacuum swallowing. Videofluoroscopic examination of swallowing (VF) was performed. High-resolution manometry (HRM) parameters, including the esophageal minimum pressure (Pmin) and maximum pressure (Pmax) in the lower esophageal sphincter (LES), were compared to the values obtained during normal swallowing. The coordination between vacuum swallowing and breathing was evaluated using SBMS. Results VF showed that pharyngeal residues in the pyriform sinus were sucked into the esophagus during vacuum swallowing. No aspiration was observed. Pmin was significantly lower, and Pmax was significantly higher during vacuum swallowing. In the SBMS study, vacuum swallowing followed an expiratory swallowing pattern; this pattern was observed in 3 out of 5 swallowing episodes in Patient 1 and all swallowing episodes in Patient 2. Deglutition apnea was observed during vacuum swallowing. Conclusion Patients could safely master vacuum swallowing. This may be a new method for improving pharyngeal bolus passage.

show abstract

“…The treatment of NPPE on extubation is to maintain a patent upper airway with jaw thrust, CPAP or Pressure Support, and administer supplemental oxygen in order to maintain adequate tissue oxygenation [5]. The differential diagnoses for perioperative hypoxemia are listed in Table 2.…”

Section: Discussionmentioning

confidence: 99%

Negative Pressure Pulmonary Edema on Extubation of a 9-Month-Old Baby Boy

Feierman

Svigos²,

Salant³

et al. 2015

OJAnes

View full text Add to dashboard Cite

Background: Negative Pressure Pulmonary Edema (NPPE) is an uncommon, but well recognized clinical entity that continues to be reported as a complication of upper airway obstructions during induction or emergence. It results from the negative intrathoracic pressure generated with spontaneous ventilation with concurrent upper airway obstruction. Aim: To present an unusual case of NPPE and review the pathophysiology and treatment. Case: It usually occurs in young healthy athletic adults. We are reporting NPPE in a nine-month-old ex-premature baby. We discuss his intraoperative events leading to NPPE, subsequent intraoperative course and treatment. Conclusion: NPPE needs to be promptly recognized and treated. If the edema resolves, the patient can be successfully extubated, but should be observed overnight.

show abstract

A case of negative pressure pulmonary edema in an asthmatic patient after laparoscopic cholecystectomy

Cited by 5 publications

References 12 publications

Synthetic Phenylpiperidine Derivative Meperidine as a Trigger for Type I Negative Pressure Pulmonary Edema in General Anesthesia

Synthetic Phenylpiperidine Derivative Meperidine as a Trigger for Type I Negative Pressure Pulmonary Edema in General Anesthesia

Mastering Vacuum Swallowing to Improve Pharyngeal Bolus Passage by Creating Negative Pressure in the Esophagus

Negative Pressure Pulmonary Edema on Extubation of a 9-Month-Old Baby Boy

Contact Info

Product

Resources

About