Negative pressure pulmonary edema after acute upper airway obstruction.
OBJECTIVE
To review the clinical characteristics and the pathogenesis of negative pressure pulmonary edema, and to determine its incidence in surgical patients.


METHODS
Retrospective case-report study.


METHODS
Operating room, postanesthesia care unit and surgical intensive care of a teaching hospital.


METHODS
30 surgical adult ASA physical status I, II, III, IV, and V patients who suffered from negative pressure pulmonary edema during the period 1992-1995.


RESULTS
This study showed a rapid onset of negative pressure pulmonary edema after acute upper airway obstruction, due mainly to laryngospasm in the postoperative period and to upper airway pathology in the preoperative period. Negative pressure pulmonary edema appeared more frequent in healthy (ASA physical status I and II), middle-aged and male patients, with a general incidence of 0.094%. The resolution was relatively rapid after reestablishment of the airway, adequate oxygenation, and positive airway pressure application. The clinical course was uncomplicated in all the patients.


CONCLUSIONS
In this study, negative pressure pulmonary edema presented a relatively high incidence. Prevention, early diagnosis, and prompt treatment allowed a rapid and uncomplicated resolution.
Deepika
K
K
Department of Anesthesiology, University of Miami School of Medicine, FL, USA.
Kenaan
C A
CA
Barrocas
A M
AM
Fonseca
J J
JJ
Bikazi
G B
GB
D000208:Acute Disease; D000328:Adult; D000402:Airway Obstruction / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011654:Pulmonary Edema / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D015919:Ventilators, Negative-Pressure