Post obstructive pulmonary oedema

Dr Henry Knipe and Dr Yuranga Weerakkody et al.

Post-obstructive pulmonary oedema is type of non-cardiogenic pulmonary oedema, and is an uncommon, but well-described, complication of upper airway obstruction. 

It essentially occurs in three clinical settings 6

  • acute airway obstruction
  • chronic upper airway obstruction
  • immediately after the relief of acute upper airway obstruction

Two different mechanisms have been proposed for the development of pulmonary oedema in the setting of upper airway obstruction 1:

  • due to significant fluid shifts due to changes in intrathoracic pressure creating a hydrostatic transpulmonary gradient with fluid moving from high pressure (pulmonary venous system) to low pressure (pulmonary interstitium and airspaces)
  • disruption of the alveolar epithelial and pulmonary microvascular membranes from severe mechanical stress, leading to increased pulmonary capillary permeability and protein-rich pulmonary oedema
Aetiology

The most common cause of postobstructive pulmonary oedema is laryngospasm during intubation or after anaesthesia in the post-operative period.

Patients in whom post-obstructive pulmonary oedema develop generally have an uncomplicated hospital course followed by the rapid resolution 1.

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Article information

rID: 17259
System: Chest
Section: Gamuts
Tag: cases
Synonyms or Alternate Spellings:
  • Post-obstructive pulmonary oedema
  • Post obstructive pulmonary edema
  • Laryngospasm included pulmonary oedema

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Cases and figures

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    Laryngospasm-indu...
    Case 1: laryngospasm-induced
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    Case 2: negative pressure pulmonary oedema
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