Abstract

An episode of non-cardiogenic lung edema in a young, healthy athlete This article describes a case of a healthy, active 17-year-old man who underwent an elective endoscopic repair of an inguinal hernia under general anesthesia. After being extubated, he experienced a sudden episode of severe hypoxemic respiratory failure in the recovery room. Eventually, the diagnosis of negative pressure pulmonary edema (NPPE) or post-obstructive pulmonary edema (POPE) was made. This condition involves a non-cardiogenic pulmonary edema which occurs due to the generation of highly negative intrathoracic pressures. The most common cause in the adult population is post-extubation laryngospasm, where significant inspiratory forces are exerted against a closed glottis. Young athletes are at a heightened risk of experiencing this complication because they can develop intensely negative intrathoracic pressures. Given the limited treatment options available, it is crucial to prevent this phenomenon and to promptly identify it if present. Given its rarity and relative obscurity, the authors hope to raise the awareness for this phenomenon. It is a condition that any medical professional (internists, surgeons, anesthesiologists, intensivists) may encounter in his or her practice.

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