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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
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Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals.

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Related Experiment Video

Updated: Jun 23, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

Published on: August 2, 2024

[Post-tracheal extubation pulmonary oedema - case report].

Maria de Lurdes Castro¹, Petra Chaves, Margarida Canas

¹Hospital de S. António dos Capuchos, Centro Hospitalar de Lisboa Central - EPE (CHLC - EPE).

Revista Portuguesa De Pneumologia

|April 30, 2009

Summary

Negative pressure pulmonary edema is a rare complication of tracheal extubation, often caused by upper airway obstruction. This case highlights the importance of recognizing and preventing this serious post-anesthetic respiratory issue.

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Area of Science:

Anesthesiology
Pulmonology
Critical Care Medicine

Background:

Negative pressure pulmonary edema (NPPE) is a rare but serious complication following tracheal extubation, occurring in approximately 0.1% of cases.
It is primarily associated with acute upper airway obstruction, leading to significant negative intrathoracic pressure.
Understanding the pathophysiology is crucial for timely diagnosis and management.

Observation:

A 15-year-old patient developed post-extubation pulmonary edema after surgery for a traumatic leg amputation.
The obstruction likely resulted from glottis closure during the post-extubation period.
This case underscores the potential for NPPE in diverse surgical scenarios.

Findings:

The key finding is the development of pulmonary edema due to forceful inspiratory efforts against an obstructed airway.
This generates negative intrathoracic pressure, causing fluid to move from pulmonary capillaries into the interstitium.
Radiological findings would typically show signs of pulmonary edema.

Implications:

Early recognition of risk factors, such as upper airway obstruction, is vital for preventing NPPE.
Implementing preventive strategies during and after extubation can mitigate this risk.
This case emphasizes the need for vigilance in post-anesthetic respiratory monitoring.