Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2021; 9(6): 1408-1415
Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1408
Unilateral pulmonary hemorrhage caused by negative pressure pulmonary edema: A case report
Hyung Joon Park, Seung Ho Park, Un Tak Woo, Sang Yun Cho, Woo Jae Jeon, Woo Jong Shin
Hyung Joon Park, Seung Ho Park, Un Tak Woo, Sang Yun Cho, Woo Jae Jeon, Woo Jong Shin, Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, Guri 11923, Gyeonggi-do, South Korea
Author contributions: Park HJ made administrative, technical, or material support and did the literature searches; Woo UT and Park SH had full access to all of the laboratory data of the patient and the accuracy of the data analysis; Jeon WJ was involved in case report manuscript design, analysis, and interpretation of picture and laboratory data and drafted the manuscript; Cho SY and Shin WJ were involved in critical revision of the manuscript for important intellectual content; All of the authors have reviewed the manuscript and accepted it in the current form for publication.
Informed consent statement: Written informed consent was obtained from the guardian for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Woo Jong Shin, MD, PhD, Professor, Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, 153 Gyeongchoon-ro, Guri 11923, Gyeonggi-do, South Korea. swj0208@hanyang.ac.kr
Received: October 1, 2020
Peer-review started: October 1, 2020
First decision: November 26, 2020
Revised: November 28, 2020
Accepted: January 6, 2021
Article in press: January 6, 2021
Published online: February 26, 2021
Abstract
BACKGROUND

Unilateral pulmonary hemorrhage is typically reported in young and healthy men with upper respiratory tract obstruction during anesthesia in special situations. Negative pressure in the lungs is created, resulting in negative pressure pulmonary edema (NPPE).

CASE SUMMARY

A 78-year-old male patient diagnosed with spinal stenosis was admitted to receive a unilateral laminectomy with bilateral decompression. The patient had been diagnosed with hypertension four years earlier and asthma more than 70 years earlier. We experienced a unilateral alveolar hemorrhage associated with NPPE that occurred in a longstanding asthma patient who bit the intubated endotracheal tube for a short period during posture change at the end of surgery. Because diffuse alveolar hemorrhage accompanied by NPPE was caused in this case by airway obstruction in an older patient with asthma without known risk factors, anesthesiologists should be careful not to induce airway irritation during anesthesia awakening in asthma patients.

CONCLUSION

Because diffuse alveolar hemorrhage accompanied by NPPE can occur, anesthesiologists should take care not to induce airway irritation.

Keywords: Airway, Anesthesia, Asthma, Hemorrhage, Pulmonary edema, Case report, Surgery

Core Tip: In this case, because diffuse alveolar bleeding occurred after negative pressure pulmonary edema without risk factors, anesthesiologists should be careful not to induce irritation during anesthesia awakening in asthma patients.