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[Snoring and postoperative pulmonary edema].

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Two patients experienced acute upper airway obstruction and negative pressure pulmonary edema (NPPE) after ENT surgery. A history of snoring, even undiagnosed, may increase NPPE risk in surgical patients.

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Area of Science:

  • Anesthesiology
  • Pulmonology
  • Otolaryngology

Background:

  • Negative pressure pulmonary edema (NPPE) is a rare but serious complication following airway manipulation.
  • Patients undergoing ENT surgery are at risk for airway complications.
  • Obstructive sleep apnea (OSA) is a known risk factor for NPPE.

Observation:

  • Two male patients developed acute upper airway obstruction and NPPE post-extubation after uneventful ENT surgery.
  • One patient had a known diagnosis of obstructive sleep apnea syndrome.
  • The second patient reported significant snoring only after the event.

Findings:

  • The cases suggest a potential link between snoring, even undiagnosed, and the development of NPPE.
  • Airway obstruction following extubation can precipitate NPPE.
  • The pathophysiology involves increased negative intrathoracic pressure during inspiration against a blocked airway.

Implications:

  • Anesthesiologists should consider snoring history as a potential risk factor for NPPE.
  • Preoperative screening for sleep-disordered breathing may be warranted in at-risk patients.
  • Prompt recognition and management of airway obstruction are crucial to prevent NPPE.