Negative pressure pulmonary edema is a rare but serious complication following general anesthesia, which can be life-threatening if not promptly recognized and treated. Based on its pathogenesis, negative pressure pulmonary edema is classified into two types. Among them, type I negative pressure pulmonary edema is more commonly observed in clinical practice. The primary mechanism of type I involves a rapid increase in negative pressure within the pleural cavity due to the patient’s forceful inspiratory efforts against an upper airway obstruction. Meanwhile, the primary mechanism of type II is a sudden decrease in auto end-expiratory positive pressure, which develops in patients with chronic upper airway obstruction after surgical correction of these obstruction. The incidence of negative pressure pulmonary edema after endotracheal intubation for general anesthesia is relatively low, approximately 0.01-0.1%.
We report a case of negative pressure pulmonary edema in a 19-year-old male patient with no prior medical history who underwent endotracheal anesthesia for facial bone fracture fixation surgery. The patient was promptly diagnosed and managed, leading to a stable recovery and discharge.
This report highlights the importance of early recognition of negative pressure pulmonary edema and timely intervention to prevent severe complications.