Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1408
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
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).
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.
Because diffuse alveolar hemorrhage accompanied by NPPE can occur, anesthesiologists should take care not to induce airway irritation.
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.