Negative pressure pulmonary edema

Abstract

Background: Negative pressure pulmonary edema (NPPE) is a potentially life-threatening complication of acute airway obstruction that occurs when a large, negative intrathoracic pressure is generated against an obstructed upper airway. The exact prevalence and mechanism remain unknown, but some risk factors have been identified and two different entities of NPPE have been characterized. Case Report: We report a case of a healthy 23-year-old male patient who had acute pulmonary edema postoperatively. Discussion: The incidence of NPPE is difficult to ascertain. Main cause of NPPE seems to be laryngospasm after tracheal extubation. Nevertheless, some other causes and risk factors have been identified. Although the exact mechanism is uncertain, the initiating event is a markedly negative intrapleural pressure generated by a forceful inspiratory effort against an obstructed extrathoracic airway. NPPE should be suspected in an individual who has a predisposing cause after reversal of upper airway obstruction. NPPE has been classified into two types. Type 1, occurs immediately after the onset of a precipitating event, Type 2, develops after resolution of chronic upper airway obstruction. Most cases of NPPE respond promptly to appropriate immediate treatment, but best treatment is prevention. Conclusions: NPPE is a potential life-threatening complication that affect otherwise healthy patients. Despite some risk factors have been identified, any patient can present this complication. Prompt recognition and adequate management of this essentially reversible entity is of paramount importance for a better outcome. The prognosis for complete recovery is excellent.