Negative-Pressure Pulmonary Edema

Mechanical Ventilation to Minimize Progression of Lung Injury in Acute Respiratory Failure

“…During these efforts, the intravascular pressure measured in pulmonary intrathoracic vessels decreases but to a lesser extent than the esophageal or pleural pressure, resulting in increased transmural pulmonary vascular pressures (18). An example of the effects of negative pleural pressure is given by negative pressure pulmonary edema occurring in normal lung when airway resistance is increased to a very high level (19), and by the abundant literature about airway resistance induced lung edema (20,21) . Therefore negative alveolar pressures created by larger changes in pleural pressure and therefore positive changes in transvascular pressure favor lung edema, a mechanism that is amplified with increased vascular permeability.…”

Recurrent Acute Neurogenic Pulmonary Edema after Uncontrolled Seizures

“…Negative-pressure pulmonary edema (NPPE) was also considered in the differential given the reported difficult intubation. NPPE can be seen in spontaneously breathing patients who have an upper airway obstruction, most commonly infection, tumor, or laryngospasm, leading to very negative intrathoracic pressures causing pulmonary edema and hypoxemia which resolves within 48 hours [15]. The most common cause of NPPE is postextubation laryngospasm following surgery [15], yet our patient developed hypoxia and respiratory failure immediately following GTC seizures.…”

Negative-pressure pulmonary oedema following choking on a rice ball

“…Negative-pressure pulmonary oedema is a non-cardiogenic pulmonary oedema that can emerge shortly after relief of upper airway obstruction 1. Extremely large negative intrathoracic pressure against an obstructed airway leads to transudation of fluid across capillary membranes and formation of alveolar oedema.…”