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Updated: Aug 12, 2026
09:31
Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism
Published on: February 14, 2022
[Delayed negative pressure pulmonary edema]
P J Kulka1, R Issel, A Wiebalck
1Abteilung für Anästhesiologie und Intensivmedizin, Prosper-Hospital, Recklinghausen. Peter.Kulka@ruhr-uni-bochum.de
Der Anaesthesist
|March 8, 2003
Summary
A young smoker developed negative pressure pulmonary edema (NPPE) after anesthesia due to airway obstruction and forceful breathing. Prompt monitoring and supportive care led to a full recovery within hours.
Area of Science:
- Anesthesiology
- Pulmonology
- Critical Care Medicine
Background:
- Negative pressure pulmonary edema (NPPE) is a rare but serious complication following anesthesia.
- It arises from strenuous inspiratory efforts against an occluded airway, leading to significant negative intrapleural pressures.
Observation:
- A young, athletic male smoker experienced NPPE 30 minutes post-anesthesia.
- The event was preceded by laryngospasm during extubation, necessitating artificial ventilation.
- The patient recovered completely after 12 hours of supportive care.
Findings:
- The mechanism involves extreme negative intrapleural pressures (-50 to -100 mmHg) damaging pulmonary capillaries.
- This results in fluid transudation into the interstitium and increased intrapulmonary blood volume.
- NPPE can manifest with a delay of up to one hour after the inciting event.
Implications:
- Highlights the importance of vigilant monitoring for NPPE in at-risk patients, even post-operatively.
- Emphasizes prompt recognition and symptomatic management for favorable outcomes.
- Suggests that factors like smoking may influence susceptibility or severity of NPPE.
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