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Etter inspiratorisk stridor fölger lungeödem - nok en fallgruve for en anestesiolog
Engelsk titel: Lung edema follows inspiratory stridor - another pitfall for the anesthesiologist Läs online Författare: Lindenskov PH ; Hanem S ; Sponheim S Språk: Nor Antal referenser: 17 Dokumenttyp: Fallbeskrivning UI-nummer: 02101294

Tidskrift

Tidsskrift for Den Norske Laegeforening 2002;122(22)2184-6 ISSN 0029-2001 E-ISSN 0807-7096 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

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.