title: [Acute negative pressure pulmonary edema: illustration from a unusual clinical case following a postoperative recurrent laryngeal nerve palsy].
abstract: Acute postoperative negative pressure pulmonary edema (NPPE) is a respiratory complication due to upper airway obstruction occurring most commonly in the postoperative period. Pathophysiologically, NPPE is explained by the abrupt generation of highly negative intrathoracic pressure that lead to fluid transudation from the pulmonary capillaries. This observation reports an unusual case of a young patient who has undergone total thyroidectomy for multinodular goiter. The postoperative period was marked by the occurrence of bilateral recurrent laryngeal nerve palsy that was complicated by a NPPE. The outcome was favorable after mechanical ventilation with reversal of NPPE and recovery of the recurrent laryngeal nerve function. This article stresses the importance of prevention of recurrent nerve palsy during thyroid surgery. It also highlights a little known respiratory complication: the NPPE. Understanding the pathophysiology of NPPE, rapid diagnosis and appropriate therapeutic measures could prevent its potential lethal consequences.
authors.affiliation: Pôle anesthésie-réanimation, hôpital militaire Avicenne, université Cadi-Ayyad, Marrakech 40000, Maroc. younes.aissaoui@live.fr
authors.forename: Y
authors.initials: Y
authors.lastname: Aissaoui
authors.forename: H
authors.initials: H
authors.lastname: Kichna
authors.forename: M
authors.initials: M
authors.lastname: Boughalem
authors.forename: N
authors.initials: N
authors.lastname: Drissi Kamili
mesh_terms: D000328:Adult; D000399:Air Pressure; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy; D002196:Capillaries / Q000473:pathology; D005122:Exudates and Transudates / Q000502:physiology; D006801:Humans; D008297:Male; D010243:Paralysis; D011183:Postoperative Complications / Q000628:therapy*; D011654:Pulmonary Edema / Q000175:diagnosis / Q000209:etiology*; D012009:Recurrent Laryngeal Nerve; D012121:Respiration, Artificial; D013961:Thyroid Gland / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects; D014826:Vocal Cord Paralysis / Q000150:complications / Q000628:therapy*