DOI: The Greek E-Journal of Perioperative Medicine 2003; 1:69-73



We present a case of severe postoperative negative pressure pulmonary edema (NPPE) in a young male patient scheduled for elective surgery. During recovery from anesthesia the patient got agitated, bit the laryngeal mask persistently and made forceful inspiratory efforts. He soon presented severe arterial hemoglobin oxygen desaturation, later followed by expectoration of pink frothy sputum. After transient improvement in oxygenation, the patient was extubated and treated with supplemental O2, fluid restriction and diuresis. X – ray examination revealed bilateral pulmonary edema. The edema resolved within 24 hours. The episode was attributed to complete obstruction of the laryngeal mask airway during awakening from anesthesia and strenuous inspiratory efforts that presumably produced excessive negative intrathoracic pressures.

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