Negative pressure pulmonary edema following septoplasty surgery triggering acute subendocardial myocardial in farction

Kaya, Zeynettin; Tunçez, Abdullah; Gok, Umut; Gül, Enes Elvin; Altunbaş, Gökhan

doi:10.4103/1995-705x.137495

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…Contou et al [21] performed a retrospective analysis in which 15 of 149 patients with diffuse alveolar hemorrhage (DAH) underwent NPPE episodes. Moreover, there is one case showed secondary T wave and ST segment dynamic changes, [12] and two cases of secondary acute subendocardial myocardial infarction [11,14] following NPPE, which might also be associated with acidosis and hyperadrenergic response induced by dyspnea. It is implied increasing attention should be paid on the complications secondary to NPPE.…”

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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“…A total of 69 studies, all of which were case series or case reports met final inclusion criteria (Supplemental Table 2). 2,3,9–73 Studies were dated between 1977 and 2016. In total, data from 87 individual patients was accessed across 69 studies.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Negative Pressure Pulmonary Edema in Otolaryngology Procedures

Din‐Lovinescu

Trivedi

Zhang

et al. 2020

Ann Otol Rhinol Laryngol

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Objective(s): Negative pressure pulmonary edema (NPPE) is a rare perioperative complication with a potentially fatal outcome. The aim of this study was to perform a systematic review of NPPE in adult otolaryngology procedures with the goal of identifying risk factors, clinical presentation, diagnosis, management and outcomes. Methods: Systematic review performed using PubMed, Scopus, Web of Science, and Cochrane databases. Results: Sixty-nine studies including data from 87 individual patients were included in this review. Fifty-six (68%) patients were male and the average patient age was 37 years old. Type 1 NPPE occurred in 63 (72%) cases, while type 2 NPPE accounted for 20 (23%) cases. The most common procedures leading to NPPE were septoplasty, rhinoplasty or sinus surgery (n = 22, 25%), directly laryngoscopy or bronchoscopy (n = 13, 15%), and tracheostomy or cricothyroidotomy (n = 11, 13%). The most employed treatment options included diuretics (n = 55, 63%) and mechanical ventilation (n = 54, 62%). Seventy-eight (90%) patients made a full recovery with an average time to NPPE resolution of 33 hours and an average length of hospitalization of 5.6 days. Five (6%) patients had a long-term morbidity and four (5%) patients died, with age and ICU stay increasing risk for death and long-term morbidity (OR 1.044 and 7.42, respectively, P < .05). Conclusion: Septoplasty, rhinoplasty and sinus surgery account for the majority of NPPE cases in adult otolaryngology procedures. Young, healthy patients are the most commonly involved with a slight male predominance. The vast majority of patients recover fully, however there is a significant risk for morbidity and mortality.

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“…The patients were intubated for an average of 11.75 hours and three mortalities (2%) occurred (1). In a case report, it was stated that a patient who underwent septoplasty had acute myocardial infarction (AMI) after the delayed diagnosis of NPPE (8). Early diagnosis is very important in NPPE.…”

Section: Discussionmentioning

confidence: 99%

A rare case: negative-pressure pulmonary edema after routine rhinoplasty

Şencan¹,

Peker²

2023

JOCS

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Negative-pressure pulmonary edema (NPPE) is a very rare and dangeorus condition that generally occurs after general anesthesia in otorhinolaryngology practices. Post-obstructive pulmonary edema or NPPE caused by an acute pulmonary edema secondary to upper respiratory tract obstruction. Its sudden appearance in the early postoperative period can stress the surgeon and the anesthesiologist. Difficult breathing effort due to upper airway obstruction creates strong changes in intra-thoracic pressure, and high negative intrathoracic pressure increases the permeability of the alveolar capillary membrane, causing significant fluid changes in the pulmonary tissues. Treatment should be evaluated together with anesthesiologist or pulmonologist and the first goal should be to reduce the hypoxia.

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Negative pressure pulmonary edema following septoplasty surgery triggering acute subendocardial myocardial in farction

Cited by 7 publications

References 14 publications

Negative pressure pulmonary edema after general anesthesia

Negative pressure pulmonary edema after general anesthesia

Systematic Review of Negative Pressure Pulmonary Edema in Otolaryngology Procedures

A rare case: negative-pressure pulmonary edema after routine rhinoplasty

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