Negative Pressure Pulmonary Edema After General Anesthesia

Yıl 2024, Cilt: 6 Sayı: 1, 11 - 19, 30.08.2024

Osman Özgür Kılınç

https://doi.org/10.55895/sshs.1451317

Öz

Abstract
Negative pressure pulmonary oedema is a type of non-cardiogenic pulmonary oedema caused by strong inspiratory effort to overcome obstruction in the upper airways. The main mechanisms responsible for the pathophysiology are the increase in pulmonary capillary hydrostatic pressure and the increase in capillary membrane permeability that develops after the negative intrathoracic pressure increases with inspiratory effort. Although all causes that may lead to upper airway obstruction may play a role in the etiology, the most common factor is laryngospasm that develops during awakening from anaesthesia. Young male smokers under general anaesthesia are more at risk. Onset may vary from a few minutes to several hours after extubation or relief of laryngospasm. It leads to an acute respiratory failure that is potentially life-threatening and usually requires follow-up and treatment in the intensive care unit. The first step in treatment is to relieve airway obstruction and provide oxygen support. Positive pressure ventilation and use of diuretics are beneficial and usually tend to improve within 24-48 hours. The mortality rate is reported to be around 5% in case analysis reports of recent years. Since it is observed more frequently in anaesthetised patients, early diagnosis and treatment in the postoperative period is important. The aim of this review is to present a current perspective on negative pressure pulmonary oedema in the light of the literature.

Anahtar Kelimeler

Non-cardiogenic pulmonary edema, Laryngospasm, Positive pressure ventilation

Kaynakça

• Barić, A., Brčić, L., Gračan, S., Torlak Lovrić, V., Gunjača, I., Šimunac, M., Brekalo, M., Boban, M., Polasek, O., Barbalic, M., Zemunik, T., Punda, A., & Boraska Perica, V. (2017). Association of established hypothyroidism-associated genetic variants with Hashimoto’s thyroiditis. J Endocrinol Invest, 40, 1061-1067. doi: 10.1007/s40618-017-0660-8
• Baydar, T., Palabiyik, S., Sahin, G. (2009). Neopterin: Günümüzün Popüler Biyogöstergesi mi? Türkiye Klinikleri Tıp Bilimleri Dergisi, 29(5), 1280-1291.
• Berdowska, A. & Zwirska‐Korczala, K. (2001). Neopterin measurement in clinical diagnosis. J Clin Pharm Ther., 26(5), 319-329. doi: 10.1046/j.1365-2710.2001.00358.x
• Eisenhut, M. (2013). Neopterin in diagnosis and monitoring of infectious diseases. J Biomark., 2013(1), 196432. doi: 10.1155/2013/196432
• Fuchs, D., Avanzas, P., Arroyo-Espliguero, R., Jenny, M., Consuegra-Sanchez, L., & Kaski, J. C. (2009). The role of neopterin in atherogenesis and cardiovascular risk assessment. Curr Med Chem., 16(35), 4644-4653. doi: 10.2174/092986709789878247
• Gülkesen, A., Akgöl, G., Tuncer, T., Kal, G. A., Selda, T., Poyraz, A. K., & Arzu, K. (2016). Relationship between leptin and neopterin levels and disease activation parameters in patients with rheumatoid arthritis. Arch Rheumatol., 31(4), 333. doi: 10.5606/ArchRheumatol.2016.5893
• Hamerlinck, F. F. (1999). Neopterin: a review. Exp Dermatol, 8(3), 167-176. doi: 10.1111/j.1600-0625.1999.tb00367.x Kondera-Anasz, Z., & Mertas, A. (1999). Level of serum neopterin and interleukin-6 in patients with thyroid diseases. Pteridines, 10(4), 197-201. doi.org/10.1515/pteridines.1999.10.4.197
• Liontiris, M. I., & Mazokopakis, E. E. (2017). A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation. Hell J Nucl Med., 20(1), 51-56. doi: 10.1967/s002449910507
• Michalak, Ł., Bulska, M., Strząbała, K., & Szcześniak, P. (2017). Neopteryna jako marker komórkowej odpowiedzi immunologicznej. Postepy Hig Med Dosw., 71, 727-736.doi: 10.5604/01.3001.0010.3851
• Mutluay, R., & Yeğin, Z. A. (2003). Hashimoto Tiroiditi (Kronik Lenfositik Tiroidit, Struma Lymphomatosa)
• Plata-Nazar, K., Szumera, M., Łuczak, G., Liberek, A., Sznurkowska, K., Szlagatys-Sidorkiewicz, A., Lange, M., & Kamińska, B. (2015). Clinical usefulness of serum neopterin in children with juvenile idiopathic arthritis. Pteridines, 26(2), 69-72. doi: 10.1515/pterid-2015-0003
• Wagner, R., Hayatghebi, S., Rosenkranz, M., & Reinwein, D. (1993). Increased serum neopterin levels in patients with Graves' disease. Exp Clin Endocrinol, 101(04), 249-254. doi: 10.1055/s-0029-1211240
• Zdraveska, N., & Kocova M. (2012). Hashimoto thyroiditis in childhood–review of the epidemiology, genetic susceptibility and clinical aspects of the disease.Macedonian Journal of Medical Sciences, 5(3), 336-345. doi: 10.3889/MJMS.1857-5773.2012.0247