Negative Pressure Pulmonary Edema: A Case Report

Year 2019, , 583 - 586, 16.09.2019

Mehmet Kabak , Bariş Çil İclal Hocanli

https://doi.org/10.5798/dicletip.620633

Abstract

Aim: Negative pressure pulmonary edema (NPPE) is a rare postoperative complication that arises due to upper airway obstruction and appears within an hour of extubation.

Case: The patient was a 19 years-old male with no chronic diseases or complaints in his preoperative assessment. Forty-five minutes after extubation, the patient reported dyspnea, hemoptysis, chest pain and oxygen saturation was 60%. Computer Tomography (CT) scans revealed bilateral infiltration and consolidation, more prominent in the central and apical regions. His bedside echocardiogram was normal. NPPE was considered in the diagnosis; oxygen support, intravenous furosemide, nebulized salbutamol and budosenide were administered in addition to non-invasive mechanical ventilation. Two hours later, the symptoms abated. His repeat X-ray taken after 12 hours showed reduction in lung infiltrates and patient was discharged after five days.

Conclusion: Abrupt decrease in oxygen saturation after extubation, dyspnea, chest pain and hemoptysis point to negative pressure pulmonary edema; the patient must immediately be moved to the intensive care unit and promptly treated.

Keywords

Hemoptysis, pulmonary edema

Project Number

Congressl of Lung Health and Intensive Care 2019 Antalya.

References

• 1. Krodel DJ, Bittner EA, Abdulnour R, Brown R, Eikermann M. Case scenario: acute postoperative negative pressure pulmonary edema. Anesthesiology 2010; 113: 200-7. [CrossRef]
• 2. Vandse R, Kothari D, Tripathi RS, et all. Negative Pressure pulmonary edema with laryngeal mask airway use: Recognition, pathophysiology and treatment modalities. Int Crit IIIn Inj Sci 2012; 2: 98– 103. [CrossRef]
• 3. Yücel A, Öztürk E, Erdil F, Aydoğan MS, Ersoy Ö. Akut üst solunum obstrüksiyonunu takiben gelişen negatif basınçlı pulmoner ödem: Olgu sunumu. İnönü Üniversitesi Tıp Fakültesi Derg 2009; 16: 261–3.
• 4. Kara İ, Çelik B.J, Apilioğulları S, Kandemir D. Bir olgu nedeniyle negatif basınçlı akciğer ödemi. Selçuk Üniv Tıp Derg 2010; 26: 106–9.
• 5. Fıstıkçı H, Çakar N, Kırışoğlu CE, ve ark. Negatif basınç akciğer ödemi ve alveoler hemorajide non-invazif pozitif basınçlı ventilasyon. Türk Anest Rean Der 2008; 36: 178-81.
• 6. Özkan D, Arık E, Dolgun H, Gürer B, Gümüş H. Servikal diskektomi sonrası gözlenen negatif basınçlı akciğer ödemi. Anestezi Dergisi 2012; 20: 183-5.
• 7. Tuzcu K, Silay E, Gökahmetoğlu G, Canpolat H. Negatif basınçlı pumoner ödem. Tıp Araştırmaları Dergisi 2012: 10: 75-9.
• 8. Bayar A, Ülke Z, Yavru A, Şentürk M. Negatif Basınç akciğer ödem ile iki olgu sunumu. Türk Anest Rean Der Dergisi 2010; 38: 133-6.
• 9. Bayraktar YŞ, Bayraktar AM, Kumral D, Örnek D. Laringeal maske (LMA) uygulaması sonrası negatif basınçlı pulmoner ödem. JCAM 2015 Doi: 10.4328/JCAM.2302
• 10. Purtuloğlu T, Şimşek F, Kurt E. Apendektomi sonrası gelişen negatif basınçlı pulmoner ödem: Olgu sunumu. JCAM 2015 Doi: 10.4328/JCAM.1608
• 11. Austin AL, Kon A, Matteucci MJ. Respiratory Failure in a Child Due to Type 2 Postobstructive Pulmonary Edema. Pediatr Emerg Care. 2016; 32: 23-4.
• 12. Özdemir L, Özdemir B, Karabay H, et all. A Rare Cause of Non-cardiogenic Pulmonary Edema Negative Pressure Pulmonary Edema: Two Case Reports Respir Case Rep 2015; 4: 136-40.
• 13. Yıldız İ, Akgül S, Erten H, ve ark. Septoplasti Sonrası Negatif Basınçlı Akciğer Ödemi: Olgu Sunumu. GKDA Derg 21: 55-58, 2015.
• 14. Tokat S, Aydınlı B, Chavush M, TezcanB, Özgök A. Negatif Basınçlı Akciğer Ödemi. Turkiye Klinikleri J Anest Reanim 2015; 13: 46-8.