Negative Pressure Pulmonary Edema: A Case Report

Abstract

Negative pressure pulmonary edema is an uncommon complication of the extubation of theendotracheal tube. An increase in intrathoracic pressure and negative pressure of the lung causedby acute laryngeal spasm results from acute upper respiratory obstruction causing life-threateningpulmonary edema by alveolar-capillary damage is called negative pressure pulmonary edema. Wehere describe 28-years old female case the preoperative diagnosis of pelvic inflammatory diseaseundergoing exploratory laporoscopy caused negative pressure pulmonary edema while extubation.With the immediate treatment, the patient was discharged without any abnormalities.

Pulmonary edema in a pediatric cancer patient after anesthetic induction

“…Airway obstruction leading to NPPE is most often reported in the context of postextubation laryngospasm following surgery. However, in children, most reported cases are secondary to upper airway infections or tumors, and more rarely due to laryngospasm, probably the main cause in this case 3 . The pulmonary edema was probably attributed to intrapleural negative pressure associated with UAO.…”

“…In this particular case, mild collapse of the suprasternal fossa and difficult jaw thrust during induction phases may have caused upper airway obstruction (UAO). Also, his BMI was a risk factor for obstructive sleep apnea, which is a risk factor for anesthesia‐related pulmonary edema 3 …”

“…However, in children, most reported cases are secondary to upper airway infections or tumors, and more rarely due to laryngospasm, probably the main cause in this case. 3 The pulmonary edema was probably attributed to intrapleural negative pressure associated with UAO. The onset of NPPE is rapid (within minutes) but usually resolves within a few hours or days, compatible with our case.…”

“…Also, his BMI was a risk factor for obstructive sleep apnea, which is a risk factor for anesthesia-related pulmonary edema. 3 Negative pressure pulmonary edema (NPPE) or postobstructive pulmonary edema is a rare cause of acute respiratory failure that usually occurs following an intense inspiratory effort against an obstructed airway. Airway obstruction leading to NPPE is most often reported in the context of postextubation laryngospasm following surgery.…”

Negative pressure pulmonary edema after laparoscopic cholecystectomy: A case report and literature review

“…If properly treated, most patients with NPPE will have a resolution of pulmonary edema signs within 12 to 48 hours, [ 14 ] with a small number resolving within 4 hours. [ 15 ] Relief of expiratory obstruction is necessary, probably because when the acute upper airway obstruction is resolved, the negative pressure in the pleural cavity begins to decrease, exudation continues to decrease, some of the accumulated fluid is coughed up as sputum, and some is reabsorbed via lymphatic reflux, gradually reducing the signs of pulmonary edema. [ 14 ] Low-tidal-volume ventilation may be beneficial.…”