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기관내튜브 발관 후에 발생한 성대문연축에 의한 음압성 폐부종
이인구 외 중앙대학교 의과대학 의학연구소 2004 中央醫大誌 Vol.29 No.1·2
Negative pressure pulmonary edema is a potential complication secondary to acute upper airway obstruction in the early postoperative period. Two young and previously healthy males developed pulmonary edema following an episode of post-extubation laryngospasm. Pink frothy sputum, expiratory wheezing, hypoxemia, and hypercapnia were presented. So both patients were reintubated, ventilated and admitted to the intensive care unit for mechanical ventilation with PEEP. Both cases were resolved fully within 24 hours. The main mechanism of postobstructive negative pressure pulmonary edema is the multifactorial effects of large intrapleural negative pressure created by attempted inspiration against a closed glottis (Müller maneuver). Treatment of negative pressure pulmonary edema is dependent on its severity. In most cases, it is self-limiting requires supportive therapy only. But mechanical ventilation may be required and can usually be withdrawn within 24 hours.