International Journal of Medical and Dental Sciences

Open Access Open Access  Restricted Access Subscription Access

Negative Pressure Pulmonary Oedema After Routine Elective Surgery


Affiliations
1 Department of Anaesthesia and Intensive Care, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
 

Negative Pressure Pulmonary Oedema (NPPE) is known to occur in healthy subjects in the early post anaesthesia period, in the absence of fluid overload or left ventricular dysfunction. This type of non cardiogenic pulmonary oedema is also reported in literature following upper airway obstruction. We report two such cases of negative pressure pulmonary edema. Both the patients developed NPPE during postanaesthesia period due to persistent laryngospasm leading to upper airway obstruction. Both the patients were treated with diuretics, bronchodilators&antibiotics in intensive care unit. Within 24 hours the coarse crepitations disappeared and the patients were weaned off the ventilator. Awareness, early recognition and prompt treatment of negative pressure pulmonary oedema could be life saving.

Keywords

Fluid Extravasation, Negative Pressure Pulmonary Oedema, Post Anaesthesia, Laryngospasm.
User
Notifications
Font Size


  • Timby J, Reed C, Zeilender S, Glauser FL. “Mechanical” causes of pulmonary edema. Chest Care 1990;98:973–9.

  • McConkey PP. Postobstructive pulmonary oedema: A case series and review. Anaesthesia Intensive care. 2000 Feb;28(1):72-6.

  • Tami TA, Chu F, Wildes TO, Kaplan M. Pulmonary edema and acute upper airway obstruction. Laryngoscope 1986;96:506–9.

  • Visvanathan T, Kluger MT, Webb RK, Westhorpe RN. Crisis management during anaesthesia: laryngospasm. Qual Saf Health Care 2005;14:e3.

  • Dicpinigaitis PV, Mehta DC. Postobstructive pulmonary edema induced by endotracheal tube occlusion. Intensive Care Med 1995;21:1048–50.

  • Anderson AF, Alfrey D, Lipscomb AB, Jr Acute pulmonary edema: An unusual complication following arthroscopy: A report of three cases. Arthroscopy 1990;6:235–7.

  • Guinard JP. Laryngospasm-induced pulmonary edema. Int J Pediatr Otorhinolaryngol 1990;20:163–8.

  • Lathan SR, Silverman ME, Thomas BL, Waters WC. Postoperative pulmonary edema. South Med J 1999;92:313–5.

  • Goli AK, Goli SA, Byrd RP, Jr, Roy TM. Spontaneous negative pressure changes: An unusual cause of noncardiogenic pulmonary edema. J Ky Med Assoc 2003;101:317–20.

  • Moore RL, Binger CA. The response to respiratory resistance: A comparison of the effects produced by partial obstruction in the inspiratory and expiratory phases of respiration. J Exp Med 1927;45:1065–80.

  • Holmes JR, Hensinger RN, Wojtys EW. Postoperative pulmonary oedema in young athletic adults. Am J Sports Med 1991;19(4):365-71.

  • Sharma ML, Beckett N, Gormley P. Negative pressure pulmonary oedema following thyroidectomy. Can J Anaesth 2002;49:215.

  • Hochman JS, Ingbar D. Cardiogenic shock and pulmonary oedema. In: Dan L Longo, Anthony S Fauci, Dennis L kasper, Stephen L Hauser, J Larry Jameson, Joseph Loscalzo, editors. Harrison's Principles of Internal Medicine. 18th ed. USA: McGrawHill; 2012.p.2232-2236.

  • Szucs R, Floyd H. Laryngospasm induced pulmonary oedema. Radiology 1980;170:446.

  • Van Kooy MA, Gargiulo RF. Post obstructive pulmonary oedema. Am Fam Physician 2000;62:401-4.

  • Jackson FN, Rowland V, Corssen G. Laryngospasm induced pulmonary oedema, Chest 1980;78:819-21.

  • Weissman C, Damask MC, Yang J. Non cardiogenic pulmonary oedema following laryngeal obstruction. Anesthesiology1984;60:163-65.


Abstract Views: 276

PDF Views: 145




  • Negative Pressure Pulmonary Oedema After Routine Elective Surgery

Abstract Views: 276  |  PDF Views: 145

Authors

Balwinderjit Singh
Department of Anaesthesia and Intensive Care, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
Iqbal Singh
Department of Anaesthesia and Intensive Care, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
Satpal Sidhu
Department of Anaesthesia and Intensive Care, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India

Abstract


Negative Pressure Pulmonary Oedema (NPPE) is known to occur in healthy subjects in the early post anaesthesia period, in the absence of fluid overload or left ventricular dysfunction. This type of non cardiogenic pulmonary oedema is also reported in literature following upper airway obstruction. We report two such cases of negative pressure pulmonary edema. Both the patients developed NPPE during postanaesthesia period due to persistent laryngospasm leading to upper airway obstruction. Both the patients were treated with diuretics, bronchodilators&antibiotics in intensive care unit. Within 24 hours the coarse crepitations disappeared and the patients were weaned off the ventilator. Awareness, early recognition and prompt treatment of negative pressure pulmonary oedema could be life saving.

Keywords


Fluid Extravasation, Negative Pressure Pulmonary Oedema, Post Anaesthesia, Laryngospasm.

References





DOI: https://doi.org/10.18311/ijmds%2F2014%2F81301