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Article
October 24, 1977

Pulmonary Edema as a Complication of Acute Airway Obstruction

Author Affiliations

From the Departments of Surgery (Dr Oswalt) and Anesthesiology (Dr Holmstrom), and the Division of Otorhinolaryngology (Dr Gates), University of Texas Health Science Center and the Audie L. Murphy Memorial Veterans Administration Hospital, San Antonio, Tex.

JAMA. 1977;238(17):1833-1835. doi:10.1001/jama.1977.03280180037022
Abstract

Acute fulminating pulmonary edema developed in three patients after acute airway obstruction secondary to tumor, strangulation, and interrupted hanging (one case each). The common etiologic factor was vigorous inspiratory effort against a totally obstructed upper airway. Acute pulmonary edema followed the event in minutes to hours and required ventilatory assistance to maintain oxygenation. All patients eventually responded to fluid restriction, diuretics, and steroids. One case was complicated by aspiration of gastric contents following respiratory failure.

To our knowledge, this condition is previously unreported in English literature. We presume that the pathogenesis is related to alveolar and capillary damage, induced by the severe negative pressure generated by attempting to inspire against the closed upper airway.

(JAMA 238:1833-1835, 1977)

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