Neostigmine and pulmonary oedema

Abstract

SUMMARYA 1-year-old child with no pre-existing cardiac or respiratory disease developed frank pulmonary oedema after administration of a neostigmine-glycopyrrolate mixture to reverse neuromuscular blockade during general anaesthesia. Possible cardiac and extra-cardiac factors that could cause pulmonary oedema in this child were ruled out by appropriate investigations. As the pulmonary oedema manifested shortly after administration of the neostigmine-glycopyrrolate mixture, we concluded that neostigmine was the most probable cause. This article briefly reports the occurrence of events and successful management of perioperative pulmonary oedema. BACKGROUND

Negative Pressure Pulmonary Edema after Bilateral Nasal Packing following Transsphenoidal Pituitary Surgery for Nonfunctioning Pituitary Tumor

“…Neostigmine, a drug used to reverse the NMB, is occasionally implicated with NPPE by its ability to impair upper airway dilator muscle activity. 9 NPPE responds expeditiously with appropriate therapy, such as lung protective PPV and supportive care. Diuretics are administered to reverse hydrostatic gradient across pulmonary capillary membranes and hasten recovery, although their role is debatable.…”

“…Neostigmine, a drug used to reverse the NMB, is occasionally implicated with NPPE by its ability to impair upper airway dilator muscle activity. 9…”

Acute noncardiogenic pulmonary edema after neostigmine administration during the recovery period of general anesthesia

“…Bijapur and coworkers described a case of a 1-year-old child who developed acute pulmonary edema after the use of a neostigmine–glycopyrrolate mixture for reversal of neuromuscular block. [9] In all cases, the patients had no preexisting cardiac or respiratory diseases and underwent operation under general anesthesia. Neostigmine-induced ANPE was diagnosed based on the fact that ANPE occurred soon after the administration of neostigmine while other causes of ANPE were ruled out.…”

Preparation of fluorinated polyimides with low dielectric constants and low dielectric losses by combining ester groups and triphenyl pyridine structures

“…Hygroscopicity is one of the critical factors affecting the application value of interlayer dielectric materials. 21,28,30 In the natural state, water molecules with larger D k can easily enter into the PI film to increase the D k of the material, thus affecting signal conduction at high frequencies. The PIs were tested for water absorption and contact angle, and the test results are shown in Fig.…”