Pulmonary Edema With Upper Airway Obstruction

Sir.—In the April 1984 issue of AJDC, Kanter and Watchko¹ published a very interesting article entitled "Pulmonary Edema Associated With Upper Airway Obstruction." I would like to add to the authors' review of reported cases our own observation published in the Archives Françaises de Pédiatrie in 1980.² We believe that this article is worth mentioning insofar as it describes the only case reported in the neonatal period, and the patient had complete echocardiographic and hemodynamic studies. These investigations clearly showed that the increase in afterload created by the high negative intrathoracic pressure transmitted to the heart was the main pathogenic factor, confirming a concept put forward by Robotham et al.³