[Acute respiratory distress after a cycling accident]

We discuss negative pressure pulmonary edema by presenting a rare case of a 42-year-old male with no relevant medical history who presented with hypoxemia following a high-speed fall from his bicycle. Evaluation with chest X-ray and CT-scan revealed bilateral perihilar consolidations and ground glass opacifications. There was no evidence of a pneumothorax or rib fractures. Other diagnoses were ruled out and the patient was diagnosed with negative pressure pulmonary edema, most likely caused by a Müller maneuver during the accident. This condition, which can also be caused by laryngospasms after detubation, results from a sudden increase in negative intrathoracic pressure, leading to pulmonary capillary pressure increase and fluid extravasation. Treatment consisted of oxygen therapy, rapid improvement of symptoms and resolution of radiological abnormalities was present within 24 hours. This article highlights the importance of considering negative pressure pulmonary edema in patients presenting with acute hypoxemia after trauma and detubation.