Development of negative pressure pulmonary oedema secondary to postextubation laryngospasm

ABSTRACT

Negative Pressure Pulmonary Oedema [NPPE] immediately after general anaesthesia is a rare but life threatening complication, caused by an increased fluid in the interstitial spaces and alveoli due to forced inspiratory efforts against tightly closed glottis. Once developed, it impairs gas exchange and causes hypoxemia and if not treated promptly may lead to respiratory failure. Management involves maintaining airway, diuretics and positive pressure ventilation. Affected cases recover completely with appropriate treatment but death may occur if treatment is delayed. We present here three cases that developed post-extubation NPPE after short spells of laryngospasm. All of the three cases recovered completely after management with diuretics and venitlatory support with added PEEP