Delayed negative pressure pulmonary edema

A young athletic male adult (smoker) developed a pulmonary edema 30 min after the end of anaesthesia. Extubation was complicated by a laryngospasm. After artificial ventilation for 12 h the patient recovered completely.A negative pressure pulmonary edema (NPPE) develops after deep inspiratory effort...

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Bibliographic Details
Published inDer Anaesthesist Vol. 52; no. 2; pp. 132 - 136
Main Authors Kulka, P J, Issel, R, Wiebalck, A, Strumpf, M, Gehling, M
Format Journal Article
LanguageGerman
Published Germany 01.02.2003
Subjects
Adult
Air Pressure
Anesthesia, Inhalation - adverse effects
Blood Gas Analysis
Herniorrhaphy
Humans
Laryngismus - complications
Laryngismus - diagnostic imaging
Male
Pulmonary Edema - diagnostic imaging
Pulmonary Edema - etiology
Radiography
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Summary:A young athletic male adult (smoker) developed a pulmonary edema 30 min after the end of anaesthesia. Extubation was complicated by a laryngospasm. After artificial ventilation for 12 h the patient recovered completely.A negative pressure pulmonary edema (NPPE) develops after deep inspiratory efforts with an occluded airway. Such a maneuver leads to negative intrapleural pressures of -50 to -100 mmHg. This pressure gradient causes damage to the pulmonary capillaries, a transcapillary volume shift into the interstitium,and hemodynamic changes that increase the intrapulmonary blood volume. As a NPPE may occur with a delay of up to 1 h it is crucial to provide adequate monitoring for patients at risk. Symptomatic therapy usually leads to complete recovery within several hours.
Bibliography:ObjectType-Case Study-2
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ISSN:0003-2417
DOI:10.1007/s00101-002-0441-3