Rodríguez J, Muniategui I, Bárcena M, Costa J, Alvarez J
Servicio de Anestesiología y Reanimación, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña.
Rev Esp Anestesiol Reanim. 1998 Jun-Jul;45(6):251-4.
A two-years-old boy with Down's Syndrome and a small interauricular communication was given priority scheduling for adenoidectomy and tonsillectomy to correct subacute obstruction of the upper airway. The only noteworthy event during surgery was an SpO2 of 92% during mechanical ventilation with FiO2 of 0.5 from no apparent cause. The patient suffered acute respiratory insufficiency due to the post-obstructive pulmonary edema in the hours immediately following surgery. The incidence of post-obstructive pulmonary edema is higher than might be expected, as symptoms can be interpreted as aspiration pneumonitis or left ventricular failure. Given the high prevalence of adenoiditis and tonsillitis with varying degrees of airway obstruction in children, we consider it useful to report this case. Such patients should be monitored carefully in the early postoperative period.
