Pulmonary edema and acute upper airway obstruction

Abstract

Pulmonary edema following the relief of acute upper airway obstruction is unusual and unpredictable. The cause is usually attributed to pulmonary and hemodynamic changes resulting from high negative intrathoracic pressures during obstructed respiration. The incidence of this problem is not known. Why pulmonary edema develops in only certain patients is also unclear. We reviewed the records of 27 consecutive adult patients admitted and treated for acute upper airway obstruction. Three of 27 (11%) developed pulmonary edema. Age, sex, diagnosis, duration of obstruction, history of cardiopulmonary disease, and perioperative fluid administration were evaluated. No differences were noted between those who did and those who did not develop pulmonary edema. Pulmonary edema following acute upper airway obstruction appears to be more common than is generally appreciated, however, no specific factors seem related to its occurrence.

Difficult Airway Society Guidelines for the management of tracheal extubation

“…Post-obstructive pulmonary oedema occurs after 0.1% of all general anaesthetics [32,193,194]. It is more common in young muscular adults (male:female ratio 4:1) [195].…”

“…Prompt diagnosis and management usually result in clinical and radiological resolution within a few hours (unless there are secondary complications), although delayed presentation of up to two and a half hours has been described [192,193]. Death is rare and usually attributable to hypoxic brain injury at the time of the airway obstruction.…”

Negative Pressure Pulmonary Edema: Case Report

“…Transüdaya bağlı gaz alışverişinin bozulması sonucu görülen hipoksi, katekolamin salınımını arttırarak pulmoner ve kapiller basıncı daha da yükseltir ve transüdasyon artarak devam eder. [1][2][3] Postoperatif erken dönemde laringospazma bağlı görülen bir komplikasyondur, ancak nadir olarak 60 ila 90 dakikaya varan geç dönemlerde de görülebilir. 2,3 Genel populasyonda görülme sıklığı %0,094 olarak bildirilmektedir.…”

Negative Pressure Pulmonary Edema Following Foramen Magnum Decompression for Chiari Malformation Type I -Case Report-

“…7) Negative pressure pulmonary edema (NPPE) 2,6,8,9) has been reported in 11% of healthy young patients who experienced laryngospasm. 10) Negative thoracic pressure results in capillary failure, 11) and will sometimes cause alveolar hemorrhage in association with NPPE. 1,4) We describe a case of NPPE which occurred after standard surgical treatment for Chiari malformation type I.…”