Respir Case Rep. 2022; 11(2): 69-72 | DOI: 10.5505/respircase.2022.56823

A Rare Cause of Respiratory Failure: Negative Pressure Pulmonary Edema

Baþak Sayýnalp¹, Oðuz Abdullah Uyaroðlu^2
1Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye
²Department of General Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye

We report here on the successful management of a patient who developed dyspnea after an elective arthroscopic procedure and who was diagnosed with Negative Pressure Pulmonary Edema (NPPE). A 29-year-old male patient with no known medical history was admitted to our hospital due to a rotator cuff tear sustained during a military operation. An arthroscopic procedure under general anesthesia was performed; however, the patient developed dyspnea 2 hours after extubation. He was desaturated, tachypneic and began to produce frothy pink sputum. Pulmonary computed-tomography angiography revealed wide-spread ground-glass opacities in both lungs suggest-ing non-cardiogenic pulmonary edema without acute pulmonary thromboembolism. The patient was thus diagnosed with NPPE and treated with non-invasive mechanical ventilation, intravenous furosemide and inhaled short-acting beta-agonists. Significant recov-ery was observed in a couple of days, and the patient discharged after his respiratory symptoms abated. NPPE should immediately be suspected in individuals who develop respiratory failure following extubation, as it can be life threatening.

Keywords: Acute respiratory failure, negative pressu-re pulmonary edema, non-cardiac pulmonary edema.

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Solunum Yetmezliðinin Nadir Bir Nedeni: Negatif Basýnçlý Pulmoner Ödem

Baþak Sayýnalp¹, Oðuz Abdullah Uyaroðlu^2
1Hacettepe Üniversitesi Týp Fakültesi, Ýç Hastalýklarý Anabilim Dalý, Ankara
²Hacettepe Üniversitesi Týp Fakültesi, Ýç Hastalýklarý Anabilim Dalý, Genel Dahiliye Bilim Dalý, Ankara

Bu olgu sunumunda, elektif artroskopik iþlem sonrasý nefes darlýðý geliþen, negatif basýnçlý pulmoner ödem (NBPÖ) tanýsý konan ve baþarýyla tedavi edilen bir hasta sunulmuþtur. Yirmi dokuz yaþýnda, herhangi bir týbbi öyküsü olmayan erkek hasta, askeri operasyon sýrasýnda geliþen rotator manþet yýrtýðý nedeniyle hastanemize baþvurdu. Genel anestezi altýnda artroskopik iþlem yapýldý. Ancak hastada ekstübasyondan 2 saat sonra dispne geliþti. Hastada satürasyon düþüklüðü ve takipne ile birlikte ve köpüklü pembe balgam görüldü. Bilgisayarlý tomografi pulmoner anjiyografide tromboemboli saptanmayýp, her iki akciðerde kardiyojenik olmayan pulmoner ödem düþündüren yaygýn buzlu cam opasiteleri saptandý. Hasta NBPÖ tanýsý konularak invazif olmayan mekanik ventilasyon, intravenöz furosemid ve inhale kýsa etkili betaagonistler ile tedavi edildi. Birkaç gün içinde belirgin bir iyileþme görülen hasta herhangi bir solunum semptomu olmadan taburcu edildi. Ekstübasyon sonrasý solunum yetmezliði geliþen kiþilerde hayatý tehdit edici bir tablo olan NBPÖ akla gelmelidir.

Anahtar Kelimeler: Akut solunum yetmezliði, negatif basýnçlý pulmoner ödem, kardiyojenik olmayan pul-moner ödem.

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