Challenges Associated with Negative Pressure Pulmonary Oedema: A Case Report and Review
DOI:
https://doi.org/10.52609/jmlph.v5i2.175Keywords:
Anaesthetics, Anaesthesia, General, Obesity, Pulmonary OedemaAbstract
Negative pressure pulmonary oedema (NPPO) is a rare but serious complication for patients undergoing general anaesthesia. It often presents a diagnostic dilemma, thus posing significant management challenges. Despite the complexity of diagnosis, the pathophysiology and management of NPPO have been extensively studied. We present a case of NPPO in a middle-aged obese patient with high perioperative cardiac risk who underwent an emergency open appendicectomy. This case report details the anaesthetic approach to managing the patient’s complex comor-bidities, the series of events leading to the diagnosis, and subsequently the management of NPPO. We dis-cuss the challenges encountered in diagnosing and managing NPPO, and review potential preventive measures. Our conclusion underscores that diagnosis of NPPO remains challenging, and early identification of patients at risk with vigilant monitoring is crucial for timely diagnosis and effective management.
References
Rosero-Britton B, Uribe A, Stoicea N, Peri-el L, Bergese SD. Negative pressure pul-monary edema postextubation following medial nerve repair with sural graft surgery in a young patient: A case report. Medicine (United States). 2018 Dec 1;97(52):e13743
Liu R, Wang J, Zhao G, Su Z. Negative pressure pulmonary edema after general anesthesia: A case report and literature re-view. Medicine (United States). 2019 Apr;98(17):e15389.
Ma J, Liu T, Wang Q, Xia X, Guo Z, Feng Q, Zhou Y, Yuan H. Negative pressure pul-monary edema (Review). Exp Ther Med [Internet]. 2023 Aug 4;26(3):455. Available from: http://www.spandidos-publications.com/10.3892/etm.2023.12154
Budhathoki A, Wu Y. Negative pressure pulmonary edema: A case report. Journal of the Nepal Medical Association. 2020 Jul 1;58(227):491–463.
Chung F, Abdullah HR, Liao P. STOP-Bang Questionnaire. Chest. 2016 Mar;149(3):631–8.
Deepika K, Kenaan CA, Barrocas AM, Fonseca JJ, Bikazi GB. Negative pressure pulmonary edema after acute upper airway obstruction. J Clin Anesth [Internet]. 1997 Aug;9(5):403–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0952818097000706
Lemyze M, Mallat J. Understanding nega-tive pressure pulmonary edema. Intensive Care Med. 2014;40(8):1140–3.
Oswalt CE. Pulmonary edema as a compli-cation of acute airway obstruction. JAMA. 1977 Oct 24;238(17):1833.
West JB, Mathieu-Costello O. Stress failure of pulmonary capillaries: role in lung and heart disease. The Lancet. 1992 Sep;340(8822):762–7.
Hooda B, Unnithan R, Sud S, Dwivedi D, Dudeja P. Do clinical signs of recovery from neuromuscular blockade compare re-liably with objective parameters of train-of-four and double burst stimulation: An ob-servational single-center study. The Indian Anaesthetists Forum. 2020;21(2):134.
Suzuki M, Inagi T, Kikutani T, Mishima T, Bito H. Negative pressure pulmonary ede-ma after reversing rocuronium-induced neuromuscular blockade by sugammadex. Case Rep Anesthesiol. 2014;2014:1–3.
Herring WJ, Mukai Y, Wang A, Lutkiewicz J, Lombard JF, Lin L, Watkins M, Brous-sard DM, Blobner M. A randomized trial evaluating the safety profile of sugam-madex in high surgical risk ASA physical class 3 or 4 participants. BMC Anesthesiol. 2021 Dec 1;21(1).
Choi E, Yi J, Jeon Y. Negative pressure pulmonary edema after nasal fracture re-duction in an obese female patient: A case report. Int Med Case Rep J. 2015 Aug 19;8:169–71.
Onk D, Işık O, Subaşı F, Karaali S, Kuyrukluyıldız U. Negative-pressure pul-monary edema after mammoplasty: a case report. Pan African Medical Journal. 2022 May 1;42.
Jaber S, Chanques G, Jung B. Postoperative noninvasive ventilation. Anesthesiology. 2010 Feb;112(2):453-61.
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