Postextubation pulmonary edema: a case series and review

We report a series of patients with postextubation pulmonary edema who had no obvious risk factors for the development of this syndrome.

Patients identified by the pulmonary consultation service at an academic medical center were reviewed.

Fourteen cases were collected and analyzed. The average age was 34.5 years; 12 patients were male. The average BMI was 25.5. None had documented previous lung disease. Most operations were scheduled as outpatient procedures, and the type of surgery ranged from an incision and drainage of a bite wound to an open reduction-internal fixation of the radius. None of the patients had upper airway surgery. The length of surgeries ranged from 27 to 335 min. Laryngospasm was the most commonly identified obstructing event postextubation. Treatment involved airway support when needed, supplemental oxygen, and diuretics.

It would appear that all patients, especially young men, are at risk for the development of this syndrome and that the pathogenesis remains uncertain in many cases.