Mersh Rebecca, Ross Clare
Anaesthetics, St Mary's Hospital, Paddington, London, UK.
Respiratory Medicine, St Mary's Hospital, Paddington, London, UK.
BMJ Case Rep. 2018 Jul 10;2018:bcr-2017-222010. doi: 10.1136/bcr-2017-222010.
Negative pressure pulmonary oedema is well described in the literature as an uncommon but recognised complication of general anaesthe sia; negative pressure diffuse alveolar haemorrhage is a rarer consequence. We report a case of massive haemoptysis following elective general anaesthesia using a laryngeal mask airway device and sevoflurane anaesthetic maintenance. The patient had no obvious signs of laryngospasm or other cause of upper airway obstruction perioperatively. We explore the possibility that the haemoptysis was caused by clinically unapparent negative pressure generation, but also ask whether the anaesthetic agent should be considered as a culprit.
负压性肺水肿在文献中已有充分描述，是全身麻醉一种罕见但已被认识的并发症；负压性弥漫性肺泡出血则是一种更为罕见的后果。我们报告一例在使用喉罩气道装置和七氟烷维持麻醉的择期全身麻醉后发生大量咯血的病例。患者围手术期无明显喉痉挛迹象或其他上呼吸道梗阻原因。我们探讨了咯血由临床上不明显的负压产生所致的可能性，但也质疑麻醉剂是否应被视为罪魁祸首。
