[Postoperative laryngospasm may induce pulmonary edema. An unusual or overlooked complication?]

Young and healthy patients in whom laryngospasm secondary to postoperative extubation is encountered run a risk of developing pulmonary edema. The mechanism behind the edema is thought to be a strongly negative intrathoracic pressure generated by the patient's forced inspiration against a closed glottis. A net flow of fluid occurs to the interstitial space and further to the alveoli. Unusually the pulmonary edema can be noticed within a few minutes after relief of the obstruction, but occasionally it is delayed for several hours. The condition is potentially life-threatening, but usually responds favourably to positive pressure ventilation and diuretics. In anaesthesia and intensive care, it is important to be aware of the complication in order to be ready for adequate therapy when needed. We present three cases from the Central Hospital in Växjö, where pulmonary edema occurred directly following postoperative extubation.