Respir Case Rep. 2020; 9(2): 91-95 | DOI: 10.5505/respircase.2020.04557

Negative Pressure Pulmonary Edema and APRV Mode in Invasive Mechanical Ventilation: A Case Report

Esra Aktiz Býçak, Zeki Korhan, Mustafa Býçak, Osman Uzundere, Cem Kývýlcým Kaçar, Abdulkadir Yektaþ
TR. HSU. Gazi Yaþargil TRH, Diyarbakýr, Department of Anesthesiology and Reanimation

Negative pressure pulmonary edema is a condition that may develop after an acute obstruction in the upper respiratory tract, or may occur secondary to the elimination of a chronic obstruction. In this case study, we report on the successful management of the APRV mode for severe hypoxia developing after a negative pressure pulmonary edema that developed after an appendectomy. An appendectomy operation was planned by the general surgery clinic for a 33-year-old male patient weighing 85 kg with no known systemic disease history, due to a preliminary diagnosis of acute appendicitis. The patient underwent an appendectomy, after which severe laryngospasm and severe inspiratory effort developed. The patient, who developed a negative pressure pulmonary edema, was treated with the APRV mode and taken to the service on day 5 following the operation. We believe that the use of the APRV mode can dramatically improve hypoxia in cases where hypoxia cannot be corrected in invasive mechanical ventilation.

Keywords: negative pressure pulmonary edema, airway pressure release ventilation, aspiration pneumonia, appendectomy

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Negatif Basýnçlý Akciðer Ödemi ve Ýnvazif Mekanik Ventilasyonda APRV Modu: Olgu Sunumu

Esra Aktiz Býçak, Zeki Korhan, Mustafa Býçak, Osman Uzundere, Cem Kývýlcým Kaçar, Abdulkadir Yektaþ
TC.SBÜ. Gazi Yaþargil EAH, Diyarbakýr, Anesteziyoloji ve Reanimasyon kliniði

Negatif basýnçlý pulmoner ödem üst solunum yolunda meydana gelen akut týkanýklýk sonrasý veya kronik týkanýklýðýn kalkmasýna sekonder geliþebilen bir durumdur. Biz bu olgu sunumunda apendektomi sonrasý geliþen negatif basýnçlý pulmoner ödem sonrasý geliþen þiddetli hipoksi için APRV modunun baþarýlý yönetimini bildiriyoruz. Bilinen sistemik bir hastalýk öyküsü olmayan, 33 yaþýnda, 85 kilo aðýrlýðýnda, erkek hastaya akut apandisit ön tanýsý nedeniyle genel cerrahi kliniðince apendektomi operasyonu planlandý. Apendektomi ameliyatýna alýndý ve sonrasýnda ciddi laringospazm ve þiddetli inspiratuvar efor geliþti. Negatif basýnçlý akciðer ödemi geliþen hasta APRV moduyla tedavi edilerek operasyon sonrasý 5. günde servise verildi. Ýnvaziv mekanik ventilasyonda hipoksinin düzeltilemediði olgularda APRV modu kullanýmýnýn hipoksiyi dramatik þekilde düzelttiðini düþünmekteyiz.

Anahtar Kelimeler: negatif basýnçlý akciðer ödemi, airway pressure relesing ventilation, aspirasyon pnömonisi, apandektomi

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