Acute negative pressure pulmonary edema after total thyroidectomy: case report
- Journal of Anesthesia & Critical Care: Open Access
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Dayan Autran Lamego, MD,1 Tatiana Goldgaber Borges, MD,2 Luiz Eduardo Imbelloni, MD, PhD,3 Rachel Motyl Gutman, MD,2 Anna Lúcia Calaça Rivoli, MD,2 Sylvio Valença de Lemos Neto, MD, PhD,4 Ana Cristina Pinho, MD,5 Patrícia L. Procópio Lara, MD2
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Abstract
Background: Negative pressure pulmonary edema after acute upper airway obstruction is a well-described event, thought infrequently diagnosed and reported. This report aimed at presenting a case of post-extubation negative pressure pulmonary edema with successful therapeutic after using positive pressure invasive mechanical ventilation.
Case report: A female patient, 59 years old, underwent thyroidectomy with bilateral dissection. Preoperative exams showed no abnormalities. Immediately after extubation, the patient presented with sudden dyspnea and pulmonary crackles, being reintubated, transferred to the ICU, subsequent tracheostomy. She was discharged home with a metal cannula and two months later its removal was performed.
Conclusion: NPPE is a difficult entity to diagnose and should be observed whenever patients develop signs and symptoms of post-extubation respiratory failure. Early diagnosis, reintubation subsequent tracheostomy allowed patients to return to their activities two months after the metal cannula was removed.
Keywords
Negative pressure pulmonary edema, positive pressure invasive mechanical ventilation, laryngospasm, tracheostomy
