Acute Negative Pressure Pulmonary Edema Following Upper Gastrointestinal (GI) Endoscopy: A Case Report

Area of Science:

• Pulmonology
• Critical Care Medicine

Background:

• Acute pulmonary edema with negative pressure (APENP) is a rare respiratory complication.
• It is typically associated with acute upper airway obstruction, often postoperatively.

Observation:

• A case of APENP outside of orotracheal intubation is presented.
• A 65-year-old woman developed respiratory distress after digestive endoscopy under sedation without tracheal intubation.
• Imaging revealed diffuse bilateral alveolar syndrome, and echocardiography excluded cardiac causes.

Findings:

• Management included oxygen therapy and diuretics.
• Mechanical ventilation was not required.
• Rapid clinical improvement and resolution of alveolar syndrome were observed on follow-up imaging.

Implications:

• This case expands the understanding of APENP triggers beyond typical postoperative scenarios.
• Prompt diagnosis and appropriate management, including non-invasive methods, are crucial for favorable outcomes.
• Awareness of APENP in non-intubated patients undergoing procedures with sedation is important for clinicians.