Document Detail

Negative pressure pulmonary edema after a tonsillectomy and adenoidectomy in a pediatric patient: case report and review.
MedLine Citation:
PMID:  10876434     Owner:  NLM     Status:  MEDLINE    
Negative pressure pulmonary edema (NPPE) continues to be reported as a complication of upper airway obstructions seen by anesthesia providers during induction or emergence. The majority of patients reported to have experienced NPPE have been healthy, without underlying pulmonary or cardiac disease. Factors associated with the formation of NPPE include young male patients and patients with long periods of airway obstruction. Overzealous intraoperative fluid administration and preexisting heart and lung disease also have been implicated as predisposing factors. Negative pressure pulmonary edema is the result of a marked decrease in intrathoracic pressure caused by ventilatory efforts against a closed glottis resulting in a disruption of the normal intravascular Starling mechanism, ultimately leading to the transudation of intravascular proteins and fluid into the pulmonary interstitium. The onset of NPPE is usually rapid, and without prompt recognition and intervention, the outcome can be fatal. A case of NPPE in a pediatric patient after an otherwise uncomplicated surgical procedure was observed in our institution and is described in this report.
C L Thomas; T J Palmer; P Shipley
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  AANA journal     Volume:  67     ISSN:  0094-6354     ISO Abbreviation:  AANA J     Publication Date:  1999 Oct 
Date Detail:
Created Date:  2000-07-13     Completed Date:  2000-07-13     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0431420     Medline TA:  AANA J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  425-30     Citation Subset:  N    
Oakland University-Beaumont Graduate Program of Nurse Anesthesia, Royal Oak, Mich., USA.
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MeSH Terms
Adenoidectomy / adverse effects*
Airway Obstruction / diagnosis,  etiology*,  physiopathology,  therapy
Primary Prevention / methods
Pulmonary Edema / diagnosis,  etiology*,  physiopathology,  therapy
Time Factors
Tonsillectomy / adverse effects*

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