Department of Anesthesiology and Operative Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, 50937, Germany.
BMC Anesthesiol. 2024 Nov 1;24(1):397. doi: 10.1186/s12871-024-02785-2.
Postoperative negative pressure pulmonary edema (NPPE) can occur in any patient undergoing general anesthesia. There are several risk factors for it, especially postoperative laryngospasm. The disease is usually benign and quickly reversible. In our case the severity and need for advanced critical care therapy was unusual.
We report a severe case of postoperative negative pressure pulmonary edema in a 62-year-old male patient undergoing elective right-sided retroperitoneoscopic adrenalectomy. The patient developed a severe case of acute respiratory distress syndrome (ARDS) after postoperative laryngospasm, possibly in conjunction with a suspected anaphylactic reaction. The patient was consequently treated with a combination of invasive airway pressure release ventilation (APRV) and a prone positioning regimen. After drastic improvement in respiratory function, the patient was discharged from the intensive care unit after 10 days and from the hospital after 14 days.
NPPE is a rare but relevant complication of anesthesia and laryngospasm. The disease can basically occur in any patient undergoing general anesthesia and therefore should be considered.
全身麻醉后会发生负压性肺水肿（NPPE），任何接受全身麻醉的患者都可能发生。其有几个风险因素，尤其是术后喉痉挛。该病通常为良性，可迅速逆转。在我们的病例中，疾病的严重程度和对高级重症监护治疗的需求是不寻常的。
我们报告了一例 62 岁男性患者在接受择期右侧后腹腔镜肾上腺切除术时发生的严重术后负压性肺水肿病例。该患者在术后喉痉挛后发生严重急性呼吸窘迫综合征（ARDS），可能伴有疑似过敏反应。因此，该患者接受了侵入性气道压力释放通气（APRV）和俯卧位治疗方案的联合治疗。在呼吸功能急剧改善后，患者在 10 天后从重症监护病房出院，14 天后从医院出院。
NPPE 是麻醉和喉痉挛的罕见但相关的并发症。这种疾病基本上可以发生在任何接受全身麻醉的患者中，因此应予以考虑。
