The Clinical Characteristics of Negative Pressure Pulmonary Edema

Negative pressure pulmonary edema (NPPE) or postobstructive pulmonary edema (POPE) is a form of noncardiogenic pulmonary edema that results from the generation of high negative intrathoracic pressure needed to overcome upper airway obstruction 1. It typically develops rapidly and can be life-threatening if not diagnosed promptly. Following an episode of acute airway obstruction or the relief of chronic upper airway obstruction, patients with NPPE develop sudden, unexpected and often severe pulmonary edema. Awareness of this uncommon condition is crucial if the physician is to make an early diagnosis and initiate successful treatment. NPPV may develop in several clinical situations follows a sudden, severe episode of upper airway obstruction, such as postanesthetic laryngospasm, postextubation laryngospasm, epiglottitis, croup, choking and strangulation. It also develops after surgical relief of chronic upper airway obstruction. (J Intern Med Taiwan 2015; 26: 63-68)