Postoperative Pulmonary Edema Conundrum: A Case of Negative Pressure Pulmonary Edema.
Pramod K GuruAnjali AgarwalMario PimentelDiane C McLaughlinVikas BansalPublished in: Case reports in critical care (2018)
Postobstructive pulmonary edema (POPE) also known as negative pressure pulmonary edema (NPPE) is an underdiagnosed entity in clinical practice and can lead to life-threatening hypoxemia. A 64-year-old male patient's perioperative course was complicated by acute hypoxemic respiratory failure, after extubation following general anesthesia, following the excision of the right vocal cord papilloma. His chest X-ray showed features of pulmonary edema, EKG showed dynamic ST-T changes in the lateral leads, and echocardiography showed evidence of regional motion abnormalities. His coronaries were normal on the immediate angiogram. He was managed with lung protective mechanical ventilation strategy, diuretics, and fluid restriction. His respiratory status improved, and trachea was extubated after 10 hours of intensive care unit (ICU) stay. The case illustrates the various differentials of immediate postoperative flash pulmonary edema and ensuing appropriate management strategy.
Keyphrases
- respiratory failure
- mechanical ventilation
- pulmonary hypertension
- intensive care unit
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation
- patients undergoing
- clinical practice
- computed tomography
- magnetic resonance
- magnetic resonance imaging
- left ventricular
- case report
- respiratory tract
- acute kidney injury