Negative pressure pulmonary edema with laryngeal mask airway use: Recognition, pathophysiology and treatment modalities
Rashmi Vandse1, Deven S Kothari1, Ravi S Tripathi1, Luis Lopez1, Stanislaw P A Stawicki2, Thomas J Papadimos1
1 Department of Anesthesiology, The Ohio State University Medical Center, Columbus, Ohio, USA
2 Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
Thomas J Papadimos
Department of Anesthesiology, Room N431, 410 West Tenth Avenue, Columbus, Ohio 43210
Negative pressure pulmonary edema (NPPE) following the use of the laryngeal mask airway (LMA) is an uncommon and under-reported event. We present a case of a 58-year-old male, who developed NPPE following LMA use. After biting vigorously on his LMA, the patient developed stridor upon emergence, with concurrent appearance of blood-tinged, frothy sputum and pulmonary edema. He subsequently required three days of mechanical ventilation. After discontinuation of mechanical ventilation the patient continued to require additional pulmonary support using continuous positive airway pressure, with a full facemask, to correct the persistent hypoxemia. His roentgenographic findings demonstrated an accelerated improvement with judicious administration of intravenous furosemide.
Labels: intravenous furosemide, laryngeal mask airway, negative pressure, Pulmonary edema