Park Hyung Joon, Park Seung Ho, Woo Un Tak, Cho Sang Yun, Jeon Woo Jae, Shin Woo Jong
Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, Guri 11923, Gyeonggi-do, South Korea.
World J Clin Cases. 2021 Feb 26;9(6):1408-1415. doi: 10.12998/wjcc.v9.i6.1408.
Unilateral pulmonary hemorrhage is typically reported in young and healthy men with upper respiratory tract obstruction during anesthesia in special situations. Negative pressure in the lungs is created, resulting in negative pressure pulmonary edema (NPPE).
A 78-year-old male patient diagnosed with spinal stenosis was admitted to receive a unilateral laminectomy with bilateral decompression. The patient had been diagnosed with hypertension four years earlier and asthma more than 70 years earlier. We experienced a unilateral alveolar hemorrhage associated with NPPE that occurred in a longstanding asthma patient who bit the intubated endotracheal tube for a short period during posture change at the end of surgery. Because diffuse alveolar hemorrhage accompanied by NPPE was caused in this case by airway obstruction in an older patient with asthma without known risk factors, anesthesiologists should be careful not to induce airway irritation during anesthesia awakening in asthma patients.
Because diffuse alveolar hemorrhage accompanied by NPPE can occur, anesthesiologists should take care not to induce airway irritation.
单侧肺出血通常报道于特殊情况下麻醉期间出现上呼吸道梗阻的年轻健康男性。肺部形成负压，导致负压性肺水肿（NPPE）。
一名78岁男性患者，诊断为椎管狭窄，入院接受单侧椎板切除术及双侧减压术。该患者4年前被诊断为高血压，70多年前被诊断为哮喘。我们遇到一例与NPPE相关的单侧肺泡出血，发生在一名长期哮喘患者身上，该患者在手术结束时体位改变期间短暂咬了气管插管。由于在本病例中，NPPE伴发的弥漫性肺泡出血是由一名无已知危险因素的老年哮喘患者气道梗阻所致，麻醉医生在哮喘患者麻醉苏醒期间应注意避免诱发气道刺激。
由于可能发生NPPE伴发的弥漫性肺泡出血，麻醉医生应注意避免诱发气道刺激。
