Korean J Crit Care Med.  1997 Nov;12(2):183-186.

Pulmonary Edema due to Upper Airway Obstruction after Neck Mass Excision of the Patient with Cerebral Palsy

• Chang MS
• Cho H
• Lim HJ
• Chang SH
• Kim NS

Abstract

Because the emergence from anesthesia may be delayed in the patient with the cerebral palsy, extubation must be delayed until consciousness is recovered completely. Postoperative pulmonary edema has several causes and one of them, upper airway obstruction is rare. We had experienced pulmonary edema due to upper airway obstruction after neck mass excision in the patient with cerebral palsy, who was 21-year-old, 50 kg, male and normal preoperative laboratory data. There was no significant change in blood volume during operation for 1 hour. After operation, the patient breathed spontaneously and the endotracheal tube was extubated in the operating room. When the patient was transfered to the recovery room, he had cyanosis, intercostal and substernal retraction, and the pulse oximeter showed very low oxygen saturation. We supplied oxygen to the patient and reintubated him, and recognized the pinkish frothy sputum by suction of the endotracheal tube. On the portable chest X-ray film of the patient at the moment, hazy increased density on both lung fields indicating pulmonary edema, but the heart size was not increased. By routine treatment for pulmonary edema, the symtoms and signs of the patient were improved. He had stayed for 1 day in the SICU and then transfered to the general ward.

Keyword

Airway obstruction; Cerebal palsy; Postoperative; Pulmonary edema

MeSH Terms

Airway Obstruction*
Anesthesia
Blood Volume
Cerebral Palsy*
Consciousness
Cyanosis
Heart
Humans
Lung
Male
Neck*
Operating Rooms
Oxygen
Patients' Rooms
Pulmonary Edema*
Recovery Room
Sputum
Suction
Thorax
X-Ray Film
Young Adult
Oxygen