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Pulmonary oedema following choking: report of two cases
Insights
Pulmonary oedema (PE) can occur in children after choking incidents. This condition is caused by hypoxia and negative pleural pressure during airway obstruction, leading to fluid in the lungs.
Area of Science:
- Pediatric Medicine
- Pulmonology
- Emergency Medicine
Background:
- Choking on foreign objects is a common pediatric emergency.
- Pulmonary oedema (PE) is a serious condition characterized by fluid accumulation in the lungs.
Observation:
- Two children, aged 3.5 and 5.5 years, developed PE after choking on food items (a sweet and an orange).
- Diagnosis was confirmed via chest X-ray upon admission.
- One child was asymptomatic, while the other had mild respiratory distress despite the presence of PE.
Findings:
- Both children recovered spontaneously within 24 hours, with chest X-rays returning to normal.
- The study suggests PE formation occurs during airway obstruction.
- The proposed mechanism involves hypoxia and severe negative pleural pressure from inspiratory efforts against the obstruction.
Implications:
- Understanding the mechanism of PE in choking incidents can aid in prompt diagnosis and management.
- This highlights the potential for significant pulmonary complications even with seemingly minor airway obstructions.
- Further research into the pathophysiology of post-obstructive PE in children is warranted.
Abstract:
Two children, aged 3 1/2 and 5 1/2 years, are described. Both developed pulmonary oedema (PE) following a short episode of choking on a sweet and an orange, respectively. On admission diagnosis was made by chest X-ray. One child was asymptomatic despite PE while the other showed only mild respiratory distress. Both children recovered spontaneously and chest X-rays showed a return to normal within 24 h. The mechanism of PE production is discussed. It is suggested that oedema formation occurs during the obstruction and that it is due to hypoxia and the severe negative pleural pressure resulting from attempts to inspire against the obstructed airway. both hypoxia and severe negative pleural pressure cause an increase in pulmonary capillary pressure and transduration of fluid across the capillary membrane.