Open AccessNegative Pressure Pulmonary Edema During Tracheal Dumon Stent Implantation
Author(s) -
Fumitomo Sato,
Nobukazu Sato,
Yoshinobu Hata,
Akinobu Suzuki,
Hidenori Goto,
Hajime Otsuka,
Ryoichi Ochiai,
Keigo Takagi
Publication year - 2012
Publication title -
journal of bronchology and interventional pulmonology
Language(s) - Uncategorized
Resource type - Journals
eISSN - 1944-6586
pISSN - 1948-8270
DOI - 10.1097/lbr.0b013e3182732066
Subject(s) - medicine , preload , pulmonary edema , airway obstruction , airway , edema , mechanical ventilation , stent , pathophysiology , bronchoscopy , cardiology , surgery , anesthesia , hemodynamics , lung
Negative pressure pulmonary edema (NPPE), or acute postobstructive pulmonary edema, is caused by negative intrathoracic pressure against an obstructed upper airway. Although NPPE is generally a benign condition, several fatal cases attributed to the delay in diagnosis have been reported. We report a case of NPPE experienced during Dumon stent placement. In a 39-year-old man, unilateral NPPE developed upon relief from a right main bronchial obstruction caused by a blood clot within the Dumon. The incident indicates that the "increased preload theory" is unable by itself to explain the pathophysiology of NPPE. Although we preferred spontaneous assisted ventilation for interventional rigid bronchoscopy, the potential risk of NPPE during Dumon stent placement, especially in spontaneously breathing young, healthy patients, needs to be considered.