Negative-pressure pulmonary edema following percutaneous nephrolithotomy

Abstract

Negative pressure pulmonary edema (NPPE) or post-extubation pulmonary edema is an infrequent complication that usually occurs immediately or within several minutes after tracheal extubation in healthy, muscular adolescents and young adults. NPPE begins when upper airway obstruction occurs which causes an increase in negative intrathoracic pressure to pull fluid from the pulmonary capillary bed and into the alveoli which leads to ventilation and perfusion difficulties. Presenting here a case of bilateral renal stone posted for percutaneous nephrolithotomy under general anesthesia in prone position who desaturated immediately in the post-operative period after extubation. It also suggests the importance, prevention, diagnosis and treatment of NPPE.

Keywords

• negative-pressure pulmonary edema
• percutaneous nephrolithotomy
• prone position