Post-extubation negative pressure pulmonary edema complicating laparoscopic appendectomy: A report of two cases

Lee, Seung Eun; Chi, Kyong Choun; Jung, Yong Hun

Case Report

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2012;7(1):34-37.
Published online January 31, 2012.

Post-extubation negative pressure pulmonary edema complicating laparoscopic appendectomy: A report of two cases

Seung Eun Lee, Kyong Choun Chi, Yong Hun Jung

¹Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea. selee508@cau.ac.kr
²Department of Anesthesiology, Chung-Ang University College of Medicine, Seoul, Korea.

Abstract

We report two cases of post-extubation negative pressure pulmonary edema in otherwise healthy patients. The patients underwent laparoscopic appendectomy under general anesthesia and developed negative pressure pulmonary edema immediately after extubation. All cases fully resolved within 24 hours with supplementary oxygen. The literature suggests that post-extubation pulmonary edema occurs more frequently than is generally thought, with a frequency of 0.05-0.1% in all anesthesia, and is often unrecognized or misdiagnosed. Most cases occur in the early post-operative period, and this is potentially life-threatening condition. Therefore, anesthesiologist and surgeon are well placed to witness, investigate and manage this condition.

Key Words: Extubation, Negative pressure pulmonary edema