Negative pressure pulmonary edema - a life-threatening condition in an eye care setting: a case report

Venkatesh, Ramesh; Gautam, Poonam; Dutta, Parul; Bala, P. Manju

doi:10.1186/s13256-016-0820-z

Cited by 6 publications

(6 citation statements)

References 4 publications

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“…Other procedure that increases the risk of NPPE includes oropharyngeal, head, and neck surgery. Five [8–12] of the reported 29 cases involved upper respiratory tract surgery, and 10 [1,3,6,7,13–18] of the cases involved head and neck surgery, which may be related to tissue swelling and the sensitive dilator muscle of the upper airway in head and neck surgeries. Although our patient underwent endoscopic thyroidectomy with no wound in the neck skin, it was inevitable for neck tissue and muscle injury.…”

Section: Discussionmentioning

confidence: 99%

Negative pressure pulmonary edema after general anesthesia

et al. 2019

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Rationale:Negative pressure pulmonary edema (NPPE) is a dangerous clinical complication and potentially life-threatening emergency without prompt diagnosis and intervention during recovery period after anesthetic extubation.Patient concerns:A 25-year-old woman has undergone endoscopic thyroidectomy. After extubation, the patient developed acute respiratory distress with high airway resistance accompanied with wheezing, oxyhemoglobin saturation (SpO2) decreased to 70%. With positive pressure mask ventilation, her condition was stable, SpO2 99%. However, the patient developed pink frothy sputum with diffuse bilateral rales 30 min later after transported to surgical intensive care unit (SICU).Diagnoses:Negative pressure pulmonary edema.Interventions:The patient was undergone assisted ventilation with continuous positive airway pressure (CPAP) and furosemide 20 mg was given intravenously.Outcomes:Postoperative day (POD) 2 her condition became stable, computed tomography (CT) scan indicated the pulmonary edema disappeared. The patient was discharged 6 days later. No abnormalities were observed during following 4 weeks.Lessons:Although usually the onset of NPPE is rapid, with individual differences NPPE is still challenging. Increased vigilance in monitoring, diagnosis, and treatment are essential to prevent aggravation and further complication.

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Section: Discussionmentioning

confidence: 99%

Negative pressure pulmonary edema after general anesthesia

et al. 2019

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“…Previous literatures reported that laryngospasm associated with intubation and general anesthesia was the most common cause of upper airway obstruction leading to NPPE in adult patients [ 1 ]. NPPE caused by airway obstruction often could be life-threatening disease [ 2 , 5 ]. If physician do not recognize that SAS could cause NPPE during sleep, a patient with SAS might miss an opportunity to take an adequate treatment.…”

Section: Discussionmentioning

confidence: 99%

Negative pressure pulmonary edema related with severe sleep apnea syndrome: A case report

Watanabe

Nagata

Ichige

et al. 2020

Respiratory Medicine Case Reports

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Negative pressure pulmonary edema (NPPE) caused by airway obstruction was often life-threatening. Major cause of NPPE in adult patients was reported as post-operative laryngospasm. Therefore, NPPE was recognized widely among surgeons and anesthesiologist, but physicians also could face NPPE case in several clinical situation. NPPE in this case was caused by sleep apnea syndrome (SAS) as relatively rare cause. A 65-year-old female presented to emergency department due to disturbance of consciousness during sleep. This patient had desaturation requiring oxygen administration. Computed tomography showed pulmonary edema in bilateral lung fields. Comprehensive examination had no evident organic airway obstruction, and echocardiography showed normal cardiac function. This patient had been diagnosed with severe SAS with the apnea hypopnea index of 32 times/h. Therefore, we thought that the NPPE could be caused by severe SAS in this case. Continuous positive airway pressure therapy could improve this patient's symptoms promptly, and this patient could discharge without a complication. We should consider SAS as a cause of NPPE when examining NPPE patients especially with onset during sleep.

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“…It is defined as a form of noncardiogenic pulmonary edema (NCPE) that results from the generation of high negative intrathoracic pressure following forced spontaneous breathing against upper airway obstruction after nasal or upper airway surgery. 1 It is reported that NPPE is seen in 0.1% of cases with general anesthesia requiring tracheal intubation, with postanesthetic laryngospasm is reported to be the reason in more than half of the cases. 2 Other causes of NPPE include foreign body aspiration, hematoma, smoking, obesity, delayed recovery from general anesthesia, obstructive sleep apnea syndrome, and oral and maxillofacial surgeries.…”

Section: Referencesmentioning

confidence: 99%

“…Negative pressure pulmonary edema (NPPE) is a sudden onset and life-threatening complication following general anesthesia in young healthy adults. It is defined as a form of noncardiogenic pulmonary edema (NCPE) that results from the generation of high negative intrathoracic pressure following forced spontaneous breathing against upper airway obstruction after nasal or upper airway surgery 1 . It is reported that NPPE is seen in 0.1% of cases with general anesthesia requiring tracheal intubation, with postanesthetic laryngospasm is reported to be the reason in more than half of the cases 2 .…”

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confidence: 99%

Differential Diagnosis of Negative Pressure Pulmonary Edema During COVID-19 Pandemic

Karaman

Özkaya

2020

Journal of Craniofacial Surgery

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Negative pressure pulmonary edema (NPPE) is a form of noncardiogenic pulmonary edema that typically occurs in response to an upper airway obstruction, where patients generate high negative intrathoracic pressures, leading to a pulmonary edema especially in the postoperative period. Here, we report a case of NPPE following general anesthesia that can easily be misdiagnosed as COVID-19 both radiologically and clinically during this pandemic. Twenty-year-old male was presented with sudden onset respiratory distress, tachypnea, and cyanosis just after the rhinoplasty surgery under general anesthesia. Chest radiography and thoracic computed tomography scans revealed the bilateral patchy alveolar opacities with decreased vascular clarity that looks similar to COVID-19 radiology. Negative pressure pulmonary edema is a sudden onset and life-threatening complication following general anesthesia particularly after head and neck surgery in young healthy individuals. It is a clinical condition that cannot be diagnosed unless it comes to mind. While both NPPE and COVID-19 cause hypoxemia and respiratory distress, as well as ground-glass opacities in the chest computed tomography, those opacities in NPPE appear mostly in central areas, whereas those opacities are mostly seen in peripheral areas in COVID-19. Furthermore, while NPPE cause decreased vascular clarity, COVID-19 causes vascular dilatations in the areas of opacities. Those differences together with medical history of the patient is crucial to differentiate these 2 similar identities. Negative pressure pulmonary edema requires an immediate recognition and intervention, therefore, we would like to raise the awareness of clinicians for such condition to avoid possible mistakes during the pandemic situation.

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Negative pressure pulmonary edema - a life-threatening condition in an eye care setting: a case report

Cited by 6 publications

References 4 publications

Negative pressure pulmonary edema after general anesthesia

Negative pressure pulmonary edema after general anesthesia

Negative pressure pulmonary edema related with severe sleep apnea syndrome: A case report

Differential Diagnosis of Negative Pressure Pulmonary Edema During COVID-19 Pandemic

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