Etter inspiratorisk stridor fölger lungeödem - nok en fallgruve for en anestesiolog
Engelsk titel: Lung edema follows inspiratory stridor - another pitfall for the anesthesiologist
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Författare:
Lindenskov PH
;
Hanem S
;
Sponheim S
Email: p.h.h.lindenskov@klinmed.uio.no
Språk: Nor
Antal referenser: 17
Dokumenttyp:
Fallbeskrivning
UI-nummer: 02101294
Sammanfattning
INTERPRETATION : The triggering mechanism of lung oedema in airway obstruction is the negative intrathoracal pressure generated because of forced inspiratory effort. This pressure is transformed to a negative interstitial hydrostatic pressure that according to Starling's hypothesis on capillary filtration may generate a lung oedema. We conclude that our patient with nasal polyps had a lowered threshold for developing lung oedema faced with postextubatory complications causing inspiratory stridor. Pathogenic mechanisms are discussed.
MATERIAL AND RESULTS : We refer to a four-year-old boy anaesthesized for elective adenotomia and paracentesis. After being extubated, he developed a moderate inspiratory stridor lasting for hours. Clinically he normalized in two hours on a therapy with oxygen in a mask with continuous positive airway pressure (CPAP) and finally bronchodilator therapy with epinephrine and salbutamol. Successive lung X-rays showed lung oedema almost normalizing in 48 hours.
BACKGROUND : Patients with heart failure or elevated intracranial pressure are at risk of developing lung oedema when anaesthesized. Lung oedema may develop in patients with airway obstructions as well.