Acute pulmonary oedema complicating laryngospasm

Ingrams, Duncan R.; Burton, Martin J; Goodwin, A. P. L.; Graham, John

doi:10.1017/s0022215100137703

Cited by 5 publications

(1 citation statement)

References 10 publications

(4 reference statements)

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“…A total of 69 studies, all of which were case series or case reports met final inclusion criteria (Supplemental Table 2). 2,3,9–73 Studies were dated between 1977 and 2016. In total, data from 87 individual patients was accessed across 69 studies.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Negative Pressure Pulmonary Edema in Otolaryngology Procedures

Din‐Lovinescu

Trivedi

Zhang

et al. 2020

Ann Otol Rhinol Laryngol

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Objective(s): Negative pressure pulmonary edema (NPPE) is a rare perioperative complication with a potentially fatal outcome. The aim of this study was to perform a systematic review of NPPE in adult otolaryngology procedures with the goal of identifying risk factors, clinical presentation, diagnosis, management and outcomes. Methods: Systematic review performed using PubMed, Scopus, Web of Science, and Cochrane databases. Results: Sixty-nine studies including data from 87 individual patients were included in this review. Fifty-six (68%) patients were male and the average patient age was 37 years old. Type 1 NPPE occurred in 63 (72%) cases, while type 2 NPPE accounted for 20 (23%) cases. The most common procedures leading to NPPE were septoplasty, rhinoplasty or sinus surgery (n = 22, 25%), directly laryngoscopy or bronchoscopy (n = 13, 15%), and tracheostomy or cricothyroidotomy (n = 11, 13%). The most employed treatment options included diuretics (n = 55, 63%) and mechanical ventilation (n = 54, 62%). Seventy-eight (90%) patients made a full recovery with an average time to NPPE resolution of 33 hours and an average length of hospitalization of 5.6 days. Five (6%) patients had a long-term morbidity and four (5%) patients died, with age and ICU stay increasing risk for death and long-term morbidity (OR 1.044 and 7.42, respectively, P < .05). Conclusion: Septoplasty, rhinoplasty and sinus surgery account for the majority of NPPE cases in adult otolaryngology procedures. Young, healthy patients are the most commonly involved with a slight male predominance. The vast majority of patients recover fully, however there is a significant risk for morbidity and mortality.

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