Negative pressure pulmonary edema after oral and maxillofacial surgery.
Negative pressure pulmonary edema (NPPE) following upper airway obstruction (UAO) has been reported in several clinical situations. The main cause of NPPE is reported to be increased negative intrathoracic pressure. We present a case of NPPE that occurred after general anesthesia for plate removal after jaw deformity surgery. After completion of the surgery, administration of inhaled anesthetics was stopped and the patient opened his eyes on verbal command. Immediately after extubation, the patient stopped breathing and became cyanotic. Acute UAO following laryngospasm was suspected. Soon after reintubation, pink, frothy fluid came out of the endotracheal tube, and a tentative diagnosis of NPPE was made. Continuous positive airway pressure was applied. In addition, furosemide and dexamethasone were administered. By the next day, the symptoms had almost disappeared.
Mamiya
Hideki
H
Department of Dental Anesthesiology, Tokyo Dental College, Chiba, Japan. mamiya@tdc.ac.jp
Ichinohe
Tatsuya
T
Kaneko
Yuzuru
Y
D002648:Child; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007826:Laryngismus / Q000150:complications / Q000209:etiology; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D011654:Pulmonary Edema / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy