Negative pressure pulmonary edema on Proseal Laryngeal Mask Airway in Laproscopic Cholecystectomy Case
Journal Title: Journal of Indira Gandhi Institute of Medical Sciences - Year 2015, Vol 1, Issue 1
Abstract
Negative pressure pulmonary edema (NPPE) or postobstruction pulmonary edema (POPE) is a clinical entity of great relevance in anesthesiology and intensive care. The presentation of NPPE can be immediate or delayed, which therefore necessitates immediate recognition and treatment by anyone directly involved in the perioperative care of a patient.1,2 This disorder is classified as Type I or Type II.3,4Type I NPPE develops immediately after onset of acute airway obstruction and Type II NPPE develops after the relief of chronic upper airway obstruction. As Type I NPPE develops usually with upper airway acute obstruction or after manipulation of the airway surgically, some authors call it laryngeal spasm-induced pulmonary edema.5Other factors that increase the risk of Type I NPPE are hanging, strangulation, upper airway tumors, foreign bodies, epiglottitis, croup, chocking, migration of Foley's catheter balloon used to tamponade the nose in epistaxis, near drowning, endotracheal tube (ETT) obstruction, goitre, and mononucleosis Though uncommon NPPE is a life threatening complication of general anaesthesia(GA) mostly seen during obstruction developed during emergence. In healthy adults undergoing GA, the incidence of NPPE is 0.05- 0.1%.6 It is even less common with the use of LMA.7 Early recognition and proper management can ensure successful outcome.
Authors and Affiliations
Swati Singh, Nida Nawaz
Keywords
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