{"title":"气管切开术后意外负压肺水肿2例报告。","authors":"Taichi Kotani, Yusuke Naito, Chie Okuda, Shota Sonobe, Junji Egawa, Masahiko Kawaguchi","doi":"10.1186/s40981-025-00777-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Negative-pressure pulmonary edema (NPPE) often develops with upper airway obstruction, and is uncommon in secured airways, for example, after tracheostomy. Herein, we report two cases of NPPE post-tracheostomy.</p><p><strong>Case presentation: </strong>Case 1: A 69-year-old man underwent prophylactic tracheotomy for possible airway obstruction secondary to glottic carcinoma. Two hours after awakening from general anesthesia, he had difficulty expectorating and developed NPPE due to airway secretions obstructing the tracheostomy tube. Case 2: An 11-year-old boy was admitted to the intensive care unit for continuous hemodiafiltration on a ventilator under sedation. On the 76th day, the day after the tracheostomy was performed, the patient developed patient-ventilator asynchrony due to sedative withdrawal syndrome. The postulated primary mechanism was functional airway obstruction due to patient-ventilator asynchrony.</p><p><strong>Conclusion: </strong>These cases highlight the need to consider NPPE, even in patients with an airway secured with a tracheostomy.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"13"},"PeriodicalIF":0.8000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867986/pdf/","citationCount":"0","resultStr":"{\"title\":\"Unexpected negative-pressure pulmonary edema after tracheostomy: two case reports.\",\"authors\":\"Taichi Kotani, Yusuke Naito, Chie Okuda, Shota Sonobe, Junji Egawa, Masahiko Kawaguchi\",\"doi\":\"10.1186/s40981-025-00777-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Negative-pressure pulmonary edema (NPPE) often develops with upper airway obstruction, and is uncommon in secured airways, for example, after tracheostomy. Herein, we report two cases of NPPE post-tracheostomy.</p><p><strong>Case presentation: </strong>Case 1: A 69-year-old man underwent prophylactic tracheotomy for possible airway obstruction secondary to glottic carcinoma. Two hours after awakening from general anesthesia, he had difficulty expectorating and developed NPPE due to airway secretions obstructing the tracheostomy tube. Case 2: An 11-year-old boy was admitted to the intensive care unit for continuous hemodiafiltration on a ventilator under sedation. On the 76th day, the day after the tracheostomy was performed, the patient developed patient-ventilator asynchrony due to sedative withdrawal syndrome. The postulated primary mechanism was functional airway obstruction due to patient-ventilator asynchrony.</p><p><strong>Conclusion: </strong>These cases highlight the need to consider NPPE, even in patients with an airway secured with a tracheostomy.</p>\",\"PeriodicalId\":14635,\"journal\":{\"name\":\"JA Clinical Reports\",\"volume\":\"11 1\",\"pages\":\"13\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-02-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867986/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JA Clinical Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s40981-025-00777-w\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JA Clinical Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40981-025-00777-w","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Unexpected negative-pressure pulmonary edema after tracheostomy: two case reports.
Background: Negative-pressure pulmonary edema (NPPE) often develops with upper airway obstruction, and is uncommon in secured airways, for example, after tracheostomy. Herein, we report two cases of NPPE post-tracheostomy.
Case presentation: Case 1: A 69-year-old man underwent prophylactic tracheotomy for possible airway obstruction secondary to glottic carcinoma. Two hours after awakening from general anesthesia, he had difficulty expectorating and developed NPPE due to airway secretions obstructing the tracheostomy tube. Case 2: An 11-year-old boy was admitted to the intensive care unit for continuous hemodiafiltration on a ventilator under sedation. On the 76th day, the day after the tracheostomy was performed, the patient developed patient-ventilator asynchrony due to sedative withdrawal syndrome. The postulated primary mechanism was functional airway obstruction due to patient-ventilator asynchrony.
Conclusion: These cases highlight the need to consider NPPE, even in patients with an airway secured with a tracheostomy.
期刊介绍：
JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.
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