Post obstructive pulmonary edema

Postobstructive
pulmonary edema • Laryngospasm-induced unilateral pulmonary edema - Ganzer Fall bei Radiopaedia
Salam H, Laryngospasm-induced unilateral pulmonary edema. Case study, Radiopaedia.org (Accessed on 12 Feb 2023) https://doi.org/10.53347/rID-13264 • CC by-nc-sa 3.0 (modified)
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Post-obstructive pulmonary edema is a type of non-cardiogenic pulmonary edema and is an uncommon but well-described complication of upper airway obstruction.

Clinical presentation

It essentially occurs in three clinical settings:

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

Pathology

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

  • 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 edema
Etiology

The most common cause of post-obstructive pulmonary edema is laryngospasm during intubation or after anesthesia in the post-operative period.

Treatment and prognosis

Patients in whom post-obstructive pulmonary edema develops generally have an uncomplicated hospital course followed by rapid resolution .

See also