Negative pressure post-tracheal extubation alveolar hemorrhage.

N egative pressure pulmonary edema is an uncommon complication of extubation of the trachea (>0.1%) mostly caused by laryngospasm (1). Upper airway obstruction from glottis closure leads to marked inspiratory efforts, which generate very negative intrathoracic pressure. This may cause pulmonary edema (1,2) and, rarely, hemoptysis (3,4). This report is the first to document both bronchoscopic and computed tomography (CT) findings consistent with alveolar hemorrhage and capillary failure in this setting.