Severe postoperative negative pressure pulmonary edema: a case report.


Journal

BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535

Informations de publication

Date de publication:
01 Nov 2024
Historique:
received: 02 09 2024
accepted: 24 10 2024
medline: 1 11 2024
pubmed: 1 11 2024
entrez: 1 11 2024
Statut: epublish

Résumé

Postoperative negative pressure pulmonary edema (NPPE) can occur in any patient undergoing general anesthesia. There are several risk factors for it, especially postoperative laryngospasm. The disease is usually benign and quickly reversible. In our case the severity and need for advanced critical care therapy was unusual. We report a severe case of postoperative negative pressure pulmonary edema in a 62-year-old male patient undergoing elective right-sided retroperitoneoscopic adrenalectomy. The patient developed a severe case of acute respiratory distress syndrome (ARDS) after postoperative laryngospasm, possibly in conjunction with a suspected anaphylactic reaction. The patient was consequently treated with a combination of invasive airway pressure release ventilation (APRV) and a prone positioning regimen. After drastic improvement in respiratory function, the patient was discharged from the intensive care unit after 10 days and from the hospital after 14 days. NPPE is a rare but relevant complication of anesthesia and laryngospasm. The disease can basically occur in any patient undergoing general anesthesia and therefore should be considered.

Sections du résumé

BACKGROUND BACKGROUND
Postoperative negative pressure pulmonary edema (NPPE) can occur in any patient undergoing general anesthesia. There are several risk factors for it, especially postoperative laryngospasm. The disease is usually benign and quickly reversible. In our case the severity and need for advanced critical care therapy was unusual.
CASE METHODS
We report a severe case of postoperative negative pressure pulmonary edema in a 62-year-old male patient undergoing elective right-sided retroperitoneoscopic adrenalectomy. The patient developed a severe case of acute respiratory distress syndrome (ARDS) after postoperative laryngospasm, possibly in conjunction with a suspected anaphylactic reaction. The patient was consequently treated with a combination of invasive airway pressure release ventilation (APRV) and a prone positioning regimen. After drastic improvement in respiratory function, the patient was discharged from the intensive care unit after 10 days and from the hospital after 14 days.
CONCLUSION CONCLUSIONS
NPPE is a rare but relevant complication of anesthesia and laryngospasm. The disease can basically occur in any patient undergoing general anesthesia and therefore should be considered.

Identifiants

pubmed: 39482603
doi: 10.1186/s12871-024-02785-2
pii: 10.1186/s12871-024-02785-2
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

397

Informations de copyright

© 2024. The Author(s).

Références

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doi: 10.1016/j.chest.2016.03.043
Ma J, Tiantian W, Qiang X, Xiaohua G, Zhiqiang F, Yan Y, et al. Negative pressure pulmonary edema. Exp Ther Med. 2023;26:455.
doi: 10.3892/etm.2023.12154 pubmed: 37614417 pmcid: 10443067
Alb M, Tsagorgiorgas C, Meinhardt J. Negative-pressure pulmonary edeme (NPPE). Anästhesiol Intensivmed Notfallmed Schmerzther. 2006;41:64–78.
doi: 10.1055/s-2006-924969 pubmed: 16493558
Liu R, Wang J, Zhao G, Su G. Negative pressure pulmonary edema after general anesthesia: A case report and literature review. Med (United States). 2019;98:17.
Krodel DJ, Bittner EA, Abdulnour R, Brown R, Eikermann M. Case scenario: Acute postoperative negative pressure pulmonary edema. Anesthesiology. 2010;113(1):200–7.
doi: 10.1097/ALN.0b013e3181e32e68 pubmed: 20526178
Ebo DG, Clarke RC, Mertes PM, Platt PR, Sabato V, Sadleir PHM. Molecular mechanisms and pathophysiology of perioperative hypersensitivity and anaphylaxis: a narrative review. Br J Anaesth. 2019;123(1):38–49.
doi: 10.1016/j.bja.2019.01.031
Armin&Gordon. Folge #005 -Intubation is a skill, extubation is an art! Kinderanästhesie-Talk [Podcast]. URL: https://kinderanaesthesie-talk.podigee.io/7-005_isea

Auteurs

Philipp Kazuo Omuro (PK)

Department of Anesthesiology and Operative Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, 50937, Germany. philipp.omuro@uk-koeln.de.

David Sander (D)

Department of Anesthesiology and Operative Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, 50937, Germany.

Dominique Hart (D)

Department of Anesthesiology and Operative Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, 50937, Germany.

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Classifications MeSH