Delayed Resolution of Negative-Pressure Pulmonary Edema: A Case Report

延遲改善之負壓肺水腫：病例報告

楊博文(Por-Wen Yang) ； 劉正鴻(Cheng-Hung Liu) ； 李世偉(Shi-Wei Lee) ； 林炎正(Yan-Jeng Lin) ； 王立敏(Lee-Min Wang)

《中華民國急救加護醫學會雜誌》 18卷3期 (2007/09) Pp. 115-120

https://doi.org/10.30018/JECCM.200709.0003

摘要

上呼吸道阻塞可能併發急性肺水腫，此症於成人常因麻醉後引起咽喉痙攣而造成。儘早診斷並給予適當治療後，病患可於24小時內恢復。在此我們提出一位接受頸椎手術，術後在病患尚未完全恢復意識時拔除氣管內管，因而造成延遲改善的急性肺水腫之病例，該病患於重新插管與給予利尿劑治療後完全恢復。術中適當的輸液處理與確認病患即將完全清醒再拔管可以避免急性肺水腫的發生。

關鍵字

肺水腫 ； 上呼吸道阻塞 ； 延遲改善 ； 麻醉

並列摘要

Negative-pressure pulmonary edema (NPPE) is a well-described complication of upper-airway obstruction, most commonly occurring amongst adults as a consequence of postanesthetic laryngospasm. With early diagnosis and prompt treatment, patients who sustain NPPE typically have a complete recovery within 24 hours of the condition's first appearance. We herein describe the case of a patient who appeared to feature a delayed resolution of highly suspected NPPE possibly associated with perioperative crystalloid solution loading as a component of cervical spine surgery for a herniated intervertebral disc, and who was extubated when not fully awake post-surgery. Subsequent to reintubation and diuretic therapy, the patient recovered uneventfully.

並列關鍵字

pulmonary edema ； upper-airway obstruction ； delayed resolution ； anesthesia