[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 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.
Kulka
P J
PJ
Abteilung für Anästhesiologie und Intensivmedizin, Prosper-Hospital, Recklinghausen. Peter.Kulka@ruhr-uni-bochum.de
Issel
R
R
Wiebalck
A
A
Strumpf
M
M
Gehling
M
M
D000328:Adult; D000399:Air Pressure; D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D001784:Blood Gas Analysis; D059685:Herniorrhaphy; D006801:Humans; D007826:Laryngismus / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography