Case reports NEGATIVE PRESSURE PULMONARY EDEMA: A CASE REPORT

Abstract

Negative-pressure pulmonary edema (NPPE) is a noncardiogenic pulmonary edema in which a large, negative intrathoracic pressure generated against an obstructed upper airway results in the shift of fluid into the interstitium of the lungs. ⁽³⁾ It is the life-threatening complication if remain undiagnosed and untreated promptly. We present a case of NPPE that occurred after general anesthesia for ear surgery. After completion of the surgery and reversal of residual neuromuscular blockade, patient was extubated. Immediately after extubation, the patient stopped breathing and desaturated which was managed with positive pressure ventilation with bag and mask. Soon after this, patient was breathing spontaneously and maintaining saturation. After 45 mins in recovery room, patient developed coarse bilateral crepitations and pink frothy sputum on coughing and tachypnea. A tentative diagnosis of NPPE was made. Continuous positive airway pressure was applied. In addition, furosemide and nebulisation with salbutamol and budesonide were administered. By the night, the symptoms had almost disappeared and next day patient shifted to ward.

Key Words: Negative pressure pulmonary edema (NPPE); Upper airway obstruction (UAO); Continuous positive airway pressure (CPAP).