1/27. Negative pressure pulmonary oedema caused by biting and endotracheal tube occlusion--a case for oropharyngeal airways.A patient had general anaesthesia for laparoscopic surgery. She bit on and occluded her endotracheal tube during recovery from anaesthesia. Strong inspiratory efforts during airway obstruction caused negative pressure pulmonary oedema. The pulmonary oedema resolved within 24 hours. Use of an oropharyngeal airway as a bite block could have prevented this complication.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/27. Pulmonary oedema after peribulbar block.Local anaesthesia is now preferred for cataract surgery. Respiratory distress caused by pulmonary oedema is a rare, if well recognized, complication of the technique of retrobulbar block. We report this complication after the increasingly favoured peribulbar approach.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
3/27. mydriasis and acute pulmonary oedema complicating laparoscopic removal of phaechromocytoma.This report describes the perioperative management of an adrenergic crisis occurring following insufflation of the peritoneum for planned laparoscopic surgery for phaechromocytoma. Despite preoperative alpha and beta adrenergic blockade, the occurrence of acute severe hypertension, mydriasis and pulmonary oedema prior to direct surgical manipulation caused the procedure to be abandoned. The severity of the event was unusual and most likely contributed to by haemorrhagic necrosis of the tumour releasing catecholamines. serum levels of noradrenaline and adrenaline at the time were 744,600 and 166,940 pg.ml-1 respectively. Treatment included bolus doses of esmolol, nicardipine and urapidil (an alpha 1 adrenergic antagonist) by constant intravenous infusion and mechanical ventilation. Postoperative cerebral CT scan was normal. An abdominal CT showed central haemorrhagic necrosis of the tumour. Two weeks later, open surgical removal of the phaeochromocytoma was successfully performed under general anaesthesia. Induction of pneumoperitoneum for laparoscopy may be particularly hazardous in a patient with a phaeochromocytoma.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
4/27. Pulmonary oedema after ophthalmic regional anaesthesia in an unfasted patient undergoing elective surgery.An elderly female patient presenting for phaco-emulsification and intra-ocular lens implant under local anaesthesia developed pulmonary oedema after surgery and underwent emergency tracheal intubation. The pulmonary oedema may have been caused by her omission of routine oral diuretic medication before surgery and having to lie flat for the procedure. The patient had not been fasted before surgery, as is accepted practice in many hospitals. This made emergency tracheal intubation potentially hazardous. The patient made a full recovery. The issues of pre-operative assessment, fasting and the withholding of diuretic medication before elective eye surgery under local anaesthesia are discussed.- - - - - - - - - - ranking = 3keywords = anaesthesia (Clic here for more details about this article) |
5/27. Complicated negative pressure pulmonary oedema in a child with cerebral palsy.A 3-year-old child with cerebral palsy developed postextubation upper airway obstruction secondary to laryngospasm and/or masseteric spasm,which may have been triggered by the muscular spasticity and the slow recovery from inhalational anaesthesia associated with cerebral palsy. This upper airway obstruction was followed by negative pressure pulmonary oedema. The patient improved on mechanical ventilation; however, his condition was complicated with the occurrence of bilateral pneumothoraces. After release of the pneumothoraces and reexpansion of the lungs, the child developed reexpansion pulmonary oedema, culminating in acute lung injury.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
6/27. Non-fatal amniotic fluid embolism after cervical suture removal.We describe a case of pulmonary oedema occurring at 37 weeks gestation, following the attempted removal of a cervical suture under general anaesthesia. The use of an ultrasound technique to demonstrate the patient's fluid status is described. Signs of amniotic fluid embolism and how it exerts its influence on the circulation are discussed.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
7/27. Postobstructive pulmonary oedema during anaesthesia in children with mucopolysaccharidoses.We present case reports of five patients with severe forms of mucopolysaccharidoses who developed postobstructive pulmonary oedema during anaesthesia. The difficulties of anaesthesia in these patients and the particular predisposition that these patients exhibit for the development of postobstructive pulmonary oedema is discussed.- - - - - - - - - - ranking = 3keywords = anaesthesia (Clic here for more details about this article) |
8/27. Negative pressure pulmonary oedema in the medical intensive care unit.OBJECTIVE: Negative pressure pulmonary oedema (NPPE) occurring in the medical intensive care unit (MICU) is an uncommon, probably under-diagnosed, but life-threatening condition. DESIGN: Retrospective data collection. SETTING: Medical intensive care unit in a 1,500-bedded tertiary care hospital. patients AND PARTICIPANTS: Five patients were diagnosed between January 1998 and January 2002. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Five patients were diagnosed to have NPPE from different aetiologies. These were acute epiglottitis, post-stenting of right bronchus intermedius stenosis, strangulation, compression from a goitre and one patient developed diffuse alveolar haemorrhage after biting the endotracheal tube during recovery from anaesthesia. All patients responded rapidly to supplemental oxygen, positive pressure ventilation and correction of underlying aetiologies. Pulmonary oedema resolved rapidly. CONCLUSIONS: There is a large spectrum of aetiologies causing NPPE in the medical intensive care unit.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
9/27. Negative pressure pulmonary oedema following tracheal tube obstruction in a paediatric patient: a preventable anaesthesia related morbidity.The purpose of this study is to describe negative pressure pulmonary oedema due to undetected tracheal tube obstruction in a paediatric patient. A healthy 6 week-old scheduled for release of tongue-tie under general anaesthesia was noticed to be diagnosed at the preparation of the surgical site. The patient was quickly assessed, and ventilation with 100% oxygen was commenced. The heart sounds were still present. Two minutes later, pink frothy secretion was noticed in the lumen of the tracheal tube. Assisted manual ventilation was continued for about 3 hours in the intensive care unit (ICU). Clinical examination after 8 hours of oxygen therapy indicated stable vital signs and was discharged to the ward. Undetected tracheal obstruction due to unsupervised patient positioning may result in negative pressure pulmonary oedema in a paediatric patient. Improved communication between the surgical and the anaesthetic teams may prevent this morbidity.- - - - - - - - - - ranking = 2.5keywords = anaesthesia (Clic here for more details about this article) |
10/27. Fatal pulmonary oedema following laparoscopic chromopertubation.The body of a 30-year-old woman was received for autopsy. The available medical case records mentioned that she had been married for the past 3 years and had had primary infertility. She had undergone a diagnostic-cum-operative laparoscopy under general anaesthesia in a private nursing home. On laparoscopy, the internal genital organs were normal except for a fimbrial cyst on each side. Chromopertubation was done using methylene blue dye along with diagnostic dilatation and curettage. The patient was extubated and shifted to the recovery room. About 15 minutes later she developed cyanosis and became unconscious. She died despite sustained efforts at resuscitation.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
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