Negative pressure pulmonary edema

Case contributed by Dr Jayanth Keshavamurthy

Presentation

"Possible negative pressure pulmonary edema" was on the requisition.

Patient Data

Age: 25 years
Gender: Male

Name a complication after extubation seen here.

X-ray

Normal heart size. Perihilar butterfly pattern patchy haziness.

No pleural effusion. Normal vascular pedicles.

24 hours after treatment

X-ray

Interval complete response to treatment with Furosemide.  

Case Discussion

25 year old male who was stabbed in the forearm with a knife one month previously. Patient could not extend his wrist after the injury. Radial nerve injury was suspected and patient was operated for exploration and repair of radial nerve.

General endotracheal anesthesia was achieved without complications.

Intravenous Fluid
Albumin 5%: 500 mL.
Crystalloid: 2,700 mL.

Chart was reviewed. Patient received IV Lasix 20 mg chest even before the first chest radiograph was obtained.

Chest x-ray findings consistent with known provided history of negative pressure pulmonary edema.

The requesting physician was aware of the suspected mechanism of pulmonary edema but the information was not conveyed to the radiologist.

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