Negative pressure pulmonary oedema after total parotidectomy

  • Awad Ali M. Alawad Department of Surgery, Faculty of Medicine, University of Medical Sciences and Technology


Introduction: Negative pressure pulmonary edema (NPPO) is an uncommon complication of extubation of the trachea mostly caused by laryngospasm. In literature few cases have been reported.

Case report: A 27-year-old male, weighing 75 kgs, ASA status class 1, underwent total parotidectomy for pleomorphic adenoma. Postextubation, the patient became restless, tachypnoeic and started desaturating. Soon after reintubation, pink, frothy fluid came out of the endotracheal tube, and a tentative diagnosis of NPPO was made. The condition improved with diuretics, oxygenation and steroids.

Result: Portable chest radiograph was taken, which revealed bilateral fluffy shadows with normal cardiothoracic ratio. ECG and arterial blood gas analysis were normal.

Conclusion: To conclude, acute pulmonary oedema associated with obstruction of the upper airways can aggravate low morbidity surgeries, affecting mainly young patients. The knowledge of this complication and, most importantly, its prevention are crucial.


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Ghofaily LA, Simmons C, Chen L, Liu R. Negative Pressure Pulmonary Edema after Laryngospasm: A Revisit with a Case Report. Journal of anesthesia & clinical research. 2013;3(10):252.

Lemyze M, Mallat J. Understanding negative pressure pulmonary edema. Intensive care medicine. 2014;40(8):1140-3.

Kaya Z, Tuncez A, Gok U, Gul EE, Altunbas G. Negative pressure pulmonary edema following septoplasty surgery triggering acute subendocardial myocardial infarction. Heart views : the official journal of the Gulf Heart Association. 2014;15(2):46-8.

Dubey PK. Post extubation negative pressure pulmonary edema due to posterior mediastinal cyst in an infant. Annals of cardiac anaesthesia. 2014;17(2):161-3.

Vogt JF, Krombach GA, Wittekindt C, Klussmann JP, Wittekindt D. [Negative pressure pulmonary edema after peritonsillar abscess tonsillectomy.]. Hno. 2013.

Sun J, Jin D, Xu Y, Li M. [Negative pressure pulmonary edema with upper airway obstruction: analysis of 3 patients]. Zhonghua er ke za zhi Chinese journal of pediatrics. 2014;52(7):531-4.

Kapoor MC. In response to "Post extubation negative pressure pulmonary edema due to posterior mediastinal cyst in an infant": is there reasonable evidence? Annals of cardiac anaesthesia. 2014;17(3):249-50.

Hong SO, Chung JY, Lee DW. Quick and accurate measures in negative pressure pulmonary edema: a guideline for orthognathic surgeons. The Journal of craniofacial surgery. 2014;25(5):e433-5.

How to Cite
Alawad AA. Negative pressure pulmonary oedema after total parotidectomy. AMS [Internet]. 21May2015 [cited 22Feb.2020];2(1):37-8. Available from:
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