[Negative pressure pulmonary edema. Post-obstructive lung edema after use of a laryngeal mask].
A 31-year-old male patient was scheduled for surgical treatment of a distal radius fracture under general anaesthesia using a laryngeal mask airway and spontaneous ventilation. The intraoperative course was uneventful. During recovery, the patient strongly bit the laryngeal mask, producing a complete obstruction of the artificial airway in combination with very forceful inspiratory efforts until the mask was removed. In the recovery room the patient developed dyspnea and desaturation. A portable chest radiograph demonstrated bilateral alveolar infiltration suggesting pulmonary edema. The patient was transferred to the intensive care unit where drug therapy (furosemide and hydrocortisone) and treatment with the continuous flow continuous positive airway pressure (CF-CPAP) system led to complete recovery within 24 h.
Sickmann
K
K
Institut für Anästhesie und Intensivmedizin, Klinikum des Landkreises Deggendorf, Akademisches Lehrkrankenhaus der Medizinischen Hochschule Hannover, Perlasberger Strasse 41, 94469 Deggendorf. Kai.Sickmann@Klinikum-Deggendorf.de
Seider
R
R
Dahm
M
M
Nold
H
H
D000328:Adult; D000402:Airway Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D045422:Continuous Positive Airway Pressure; D004232:Diuretics / Q000627:therapeutic use; D005440:Fluid Therapy; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D017214:Laryngeal Masks / Q000009:adverse effects*; D008297:Male; D011650:Pulmonary Alveoli / Q000473:pathology; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011859:Radiography; D011885:Radius Fractures / Q000601:surgery
D000893:Anti-Inflammatory Agents; D004232:Diuretics; D005665:Furosemide; D006854:Hydrocortisone