Quick and Accurate Measures in Negative Pressure Pulmonary Edema

Hong, Sung Ok; Chung, Jun-Young; Lee, Deok-Won

doi:10.1097/scs.0000000000000944

Cited by 7 publications

(11 citation statements)

References 6 publications

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“…Krodel et al [5] reported that a 25-year-old man showed the symptoms of pulmonary edema within first hour after surgery without specific time window. Hong et al [6] reported the case that began to present pink frothy sputum soon after clear consciousness. Here, our patients rarely presented pink frothy sputum after reversing the upper airway obstruction-induced dyspnea, she stayed conscious and the time window was over 30 min.…”

Section: Discussionmentioning

confidence: 99%

“…Other procedure that increases the risk of NPPE includes oropharyngeal, head, and neck surgery. Five [8–12] of the reported 29 cases involved upper respiratory tract surgery, and 10 [1,3,6,7,13–18] of the cases involved head and neck surgery, which may be related to tissue swelling and the sensitive dilator muscle of the upper airway in head and neck surgeries. Although our patient underwent endoscopic thyroidectomy with no wound in the neck skin, it was inevitable for neck tissue and muscle injury.…”

Section: Discussionmentioning

confidence: 99%

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Negative pressure pulmonary edema after general anesthesia

et al. 2019

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Rationale:Negative pressure pulmonary edema (NPPE) is a dangerous clinical complication and potentially life-threatening emergency without prompt diagnosis and intervention during recovery period after anesthetic extubation.Patient concerns:A 25-year-old woman has undergone endoscopic thyroidectomy. After extubation, the patient developed acute respiratory distress with high airway resistance accompanied with wheezing, oxyhemoglobin saturation (SpO2) decreased to 70%. With positive pressure mask ventilation, her condition was stable, SpO2 99%. However, the patient developed pink frothy sputum with diffuse bilateral rales 30 min later after transported to surgical intensive care unit (SICU).Diagnoses:Negative pressure pulmonary edema.Interventions:The patient was undergone assisted ventilation with continuous positive airway pressure (CPAP) and furosemide 20 mg was given intravenously.Outcomes:Postoperative day (POD) 2 her condition became stable, computed tomography (CT) scan indicated the pulmonary edema disappeared. The patient was discharged 6 days later. No abnormalities were observed during following 4 weeks.Lessons:Although usually the onset of NPPE is rapid, with individual differences NPPE is still challenging. Increased vigilance in monitoring, diagnosis, and treatment are essential to prevent aggravation and further complication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Negative pressure pulmonary edema after general anesthesia

et al. 2019

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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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“…There are very limited case reports which present NPPE associated with dental procedures and orofacial surgery in the literature [3,[5][6][7][8][9][10]. This report aims to present the case that had NPPE after bimaxillary orthognathic surgeries and to review the reported data related to NPPE after oral procedures.…”

Section: Introductionmentioning

confidence: 99%

Negative Pressure Pulmonary Edema After Orthognathic Surgery

Çubuk¹,

Özdemirkan²,

Bayram³

2020

ERD

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Negative-pressure pulmonary edema can arise in patients having upper airway obstruction following extubation. This report aims to present the case that had negative-pressure pulmonary edema after orthognathic surgery and to review the literature. Twenty-sevenyear-old male patient underwent bimaxillary orthognathic surgery. At the postanesthesia care unit, the patient had marked respiratory distress and significant arterial oxygen desaturation. The patient was reintubated and transported to the Intensive Care Unit. Extubation was done after 6 hours and continuous positive airway pressure was applied for 2 days at the Intensive Care Unit. On the postoperative second and third day, vascular congestion resolved on the chest radiograpies. C-reactive protein, leukocyte, neutrophil counts, partial pressure of the arterial oxygen and carbon dioxide showed improvement during the treatment. Negative-pressure pulmonary edema is a life-threatening complication that can be seen after orthognathic surgery and can be managed with early diagnosis and accurate treatment protocol.

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Quick and Accurate Measures in Negative Pressure Pulmonary Edema

Cited by 7 publications

References 6 publications

Negative pressure pulmonary edema after general anesthesia

Negative pressure pulmonary edema after general anesthesia

Systematic Review of Negative Pressure Pulmonary Edema in Otolaryngology Procedures

Negative Pressure Pulmonary Edema After Orthognathic Surgery

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