title: Acute intraoperative neurogenic pulmonary edema during endoscopic ventriculoperitoneal shunt revision.
abstract: We present an incident of fulminant intraoperative neurogenic pulmonary edema in a 21-yr-old man undergoing an endoscopic ventriculoperitoneal shunt revision. His intraoperative course was complicated by intracranial bleeding requiring vigorous saline irrigation, which was accompanied by an acute increase in heart rate and arterial blood pressure. Shortly thereafter, the patient developed pulmonary edema and was promptly treated with resolution of pulmonary symptoms within 24 h. This report addresses the importance of recognition of neurogenic pulmonary edema as a possible intraoperative complication resulting from an increase in intracranial pressure due to hemorrhage and intraventricular irrigation during endoscopic ventriculoperitoneal shunt revision.
authors.affiliation: Department of Anesthesiology, Perioperative and PainMedicine, Childrens Hospital Boston, Harvard Medical School, Boston, Massachussets 02115, USA.
authors.forename: Galina
authors.initials: G
authors.lastname: Davidyuk
authors.forename: Sulpicio G
authors.initials: SG
authors.lastname: Soriano
authors.forename: Liliana
authors.initials: L
authors.lastname: Goumnerova
authors.forename: Arielle
authors.initials: A
authors.lastname: Mizrahi-Arnaud
mesh_terms: D000208:Acute Disease; D004724:Endoscopy; D004868:Equipment Failure; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D020300:Intracranial Hemorrhages / Q000209:etiology; D019586:Intracranial Hypertension / Q000209:etiology*; D007431:Intraoperative Complications / Q000628:therapy; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology* / Q000628:therapy; D012086:Reoperation; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*; D055815:Young Adult