Negative Pressure Pulmonary Edema: A Rare Complication Following Extubation

Miranda DB
2017 Austin Journal of Anesthesia and Analgesia  
We describe a case of Negative Pressure Pulmonary Edema (NPPE) followed by laryngospasm occurred immediately after extubation. A 24-year-old man underwent a surgical correction of unilateral inguinal hernia by laparoscopy. The tracheal intubation was easy with grade 1 of Cormack-Lehane classification. Anesthesia was maintained with sevoflurane 2, 5%. After fully awake extubation, nearly total upper airway obstruction due to severe laryngospasm was observed by a decrease in oxygen saturation and
more » ... the presence of large amount frothy pink sputum, suggestive of acute pulmonary edema. A nasal airway was inserted, but face mask ventilation was difficult. Oxygenation of the airway was maintained with support of non invasive ventilation for twenty four hours, with SpO 2 of 92-96 %. 48 hours later, the pulmonary edema disappeared and the patient was discharged without complications (SpO 2 96% and ambient air).
doi:10.26420/austinjanesthesiaanalgesia.2017.1052 fatcat:pm4qcbzdzjerbdbioj2tce2dya