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Updated: Aug 12, 2026

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
Abstract:
A young athletic male adult (smoker) developed a pulmonary edema 30 min after the end of anaesthesia. Extubation was complicated by a laryngospasm. After artificial ventilation for 12 h the patient recovered completely.A negative pressure pulmonary edema (NPPE) develops after deep inspiratory efforts with an occluded airway. Such a maneuver leads to negative intrapleural pressures of -50 to -100 mmHg. This pressure gradient causes damage to the pulmonary capillaries, a transcapillary volume shift into the interstitium,and hemodynamic changes that increase the intrapulmonary blood volume. As a NPPE may occur with a delay of up to 1 h it is crucial to provide adequate monitoring for patients at risk. Symptomatic therapy usually leads to complete recovery within several hours.
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