Negative pressure pulmonary oedema after total parotidectomy
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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