Post-tracheal extubation pulmonary edema in an infant - Case report; [Bebekte ekstübasyon sonrasi gelişen akciǧer ödemi - Olgu sunumu]
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Date
2007
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Abstract
Upper airway obstruction related to laryngospasm after extubation may lead to negative pressure pulmonary edema. The proposed mechanism is the generation of high negative pressures during respiratory effort associated with glottis closure and laryngospasm leading to pulmonary edema and alveolar hemorrhage. A male premature, twin baby, 2.5 month old, weighing 6 kg was scheduled to perform cystoscopy under general anesthesia for the purpose of diagnosis. After uneventful induction and operation, the infant was extubated. Approximately 5 minutes after extubation, the infant performed significant laryngospasm associated with respiratory distress, tachypnea, cyanosis and significant decrease in peripheral oxygen saturation. Consequently, the patient was reintubated and transferred to the Anesthesiology Intensive Care Unit for mechanical ventilation and further treatment. After 4 hour of mechanical ventilation support, the patient was extubated at the 6th hour. Postoperative 48th hour, he was discharged to the pediatric surgery unite. Negative pressure pulmonary edema is a serious, life-threatening, clinical condition requiring reintubation and mechanical ventilation support associated with prolonged hospital stay even in pediatric cases. Early recognition of patients at risk and preventing laryngospasm are important.