Negative pressure plmonary oedema after adenotonsillectom: a case report and litrature review

Abstract

Background: Negative pressure pulmonary is a non-cardiogenic pulmonary edema that can occur after reliving of upper airway obstruction. It is life threatening clinical scenario developed due to increase intra thoracic pressure during marked inspiratory effort against a closed glottis. Case presentation: A successful adenotonsillectomy was done for a healthy 12-year, 33 kg male patient and transferred to post anesthesia care unit. In the unit the patient developed signs and symptoms of negative pressure pulmonary edema so he was treated with diuretics & oxygen while restricting fluid. However the dyspnea was persisted so he was transferred to intensive care unit Clinical discussion: This case report shows the development of negative pressure pulmonary edema after adenotonsillectomy. In this report the clinical presentation, diagnosis, treatment, prevention and prognosis of negative pressure pulmonary edema after adenotonsillectomy was discussed in detail with citing updated evidences. Conclusions: Post extubation pulmonary edema can occur after reliving of chronic air obstruction. Usually it occur within 5 minute after reliving the obstruction but it can occur at any time. All health care professionals must be knowledgeable about clinical presentation and managements of negative pressure pulmonary edema.