We use cookies to ensure that we give you the best experience on our website Learn more

May 15, 2018

Euroanaesthesia 2018

11 / Characterizing post-extubation negative-pressure pulmonary edema in the operating room- a retrospective matched case-control study

;

complications

pulmonary oedema

intubation endobronchial

smokers

Abstract

Abstract

thumbnail

Keywords

complications

pulmonary oedema

intubation endobronchial

smokers

Abstract

Background. Post-extubation negative-pressure pulmonary edema (NPPE) is a true anesthesia-related emergency presenting with acute respiratory distress and hypoxemia after removal of airway devices. This study investigated the incidence and associated risk factors for post-extubation NPPE during emergence. Methods and Results. This retrospective, matched case-control study was conducted by reviewing the post-anesthesia records in Tzu-Chi General Hospital, Taiwan. Patients reported of having acute hypoxemia (SpO2< 92%) shortly after removal of the endotracheal tube or supraglottic airway, associating with radiographic evidence of pulmonary edema and/or pink frothy sputum were identified as definite NPPE cases. The potential risk factors were compared with the matched controls, who were randomly selected from the same database. A total of 85561 patients received general anesthesia with airway instrumentation during the 8.5-year study period. A total of 16 patients were identified as definite cases of NPPE. Compared with the matched controls (n=131), males, active smokers, emergency operation, endotracheal intubation, use of desflurane and prolonged operation time carried significantly higher risks of developing NPPE (P< 0.05). Multivariate logistic regression analysis illustrated that active smoking (AOR 7.66, 95% CI 1.67-35.3; P=0.009) and endotracheal intubation (AOR 10.87, 95% CI 1.23-100; P=0.03) were the two most significant independent variables of post-extubation NPPE. Conclusion. We present the first clinical comparative study demonstrated that the overall incidence of NPPE immediately after extubation in the operating room is 0.019%. Our results highlight that active smokers and patients receiving endotracheal intubation general anesthesia are associated with significantly higher risks of developing NPPE following extubation in the operating room.

Discover over 20,000 new abstracts, posters and presentations from leading academic conferences every month. Stay on top of the latest findings, methodologies and discussions happening in your research field around the world.

Company

Legal

Follow us

© Copyright 2019 Morressier GmbH. All rights reserved.

© Copyright 2019 Morressier GmbH.
All rights reserved.