Negative-pressure pulmonary edema

Background

• Negative-pressure pulmonary edema (NPPE) ithat occurs after a patient makes strong inspiratory effort against a blocked airway. The negative pressure causes hydrostatic edema that can be life-threatening if not but minimized if treated early, usually resolves after 24-48 hours.
• Patients have and airway obstructive process either from an allergy, laryngospasm, trauma, and commonly in the case of hangings.

Management

• Remove any obstructive processes
• Intubation is often required
• Positive pressure ventilation
• Patients with severe pulmonary edema that do not respond to standard ventilator strategies may require proning or even ECMO

Disposition

• Admission for continued monitoring often if not always in the ICU