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Negative pressure pulmonary edema following bronchospasm
David J Krodel1, Edward A Bittner1, Raja-Elie E Abdulnour2
1Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Chest
|November 3, 2011
Summary
Severe bronchospasm can trigger negative pressure pulmonary edema (NPPE), a rare form of noncardiogenic pulmonary edema. Prompt noninvasive ventilation rapidly resolved symptoms in a patient with reactive airway disease.
Area of Science:
- Anesthesiology
- Pulmonology
- Critical Care Medicine
Background:
- Negative pressure pulmonary edema (NPPE) is a recognized cause of noncardiogenic pulmonary edema.
- NPPE is typically associated with upper airway obstruction or strenuous,’”'],
Observation:
- A patient with severe reactive airway disease developed NPPE post-extubation.
- The patient experienced severe bronchospasm preceding the onset of pulmonary edema.
- Clinical and radiographic findings were consistent with pulmonary edema without signs of heart failure.
Findings:
- The case suggests a strong link between severe bronchospasm and the development of NPPE.
- Negative intrathoracic pressure generated during bronchospasm is hypothesized as the mechanism.
Implications:
- This case expands the known triggers for NPPE.
- Awareness of NPPE in bronchospasm is crucial for timely diagnosis and management.
- Noninvasive positive pressure ventilation may be an effective treatment for NPPE secondary to bronchospasm.
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