一名年轻健康的运动员突发非心源性肺水肿

D. Bivort, P. Van Bleyenbergh
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摘要

一名年轻、健康的运动员突发非心源性肺水肿 本文描述了一例健康、活泼的 17 岁男子在全身麻醉下接受腹股沟疝气择期内窥镜修补术的病例。拔管后,他在恢复室突然出现严重低氧呼吸衰竭。最终,他被诊断为负压性肺水肿(NPPE)或阻塞后肺水肿(POPE)。负压性肺水肿是一种非心源性肺水肿,由胸内高负压引起。在成人中最常见的原因是拔管后喉头痉挛,即在声门关闭的情况下产生巨大的吸力。年轻运动员出现这种并发症的风险较高,因为他们会产生强烈的胸内负压。鉴于现有的治疗方案有限,预防这种现象并在出现时及时发现至关重要。鉴于其罕见性和相对隐蔽性,作者希望提高人们对这一现象的认识。这是任何医务人员(内科医生、外科医生、麻醉师、重症监护医师)在工作中都可能遇到的情况。
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Een episode van niet-cardiogeen longoedeem bij een jonge, gezonde atleet
An episode of non-cardiogenic lung edema in a young, healthy athlete This article describes a case of a healthy, active 17-year-old man who underwent an elective endoscopic repair of an inguinal hernia under general anesthesia. After being extubated, he experienced a sudden episode of severe hypoxemic respiratory failure in the recovery room. Eventually, the diagnosis of negative pressure pulmonary edema (NPPE) or post-obstructive pulmonary edema (POPE) was made. This condition involves a non-cardiogenic pulmonary edema which occurs due to the generation of highly negative intrathoracic pressures. The most common cause in the adult population is post-extubation laryngospasm, where significant inspiratory forces are exerted against a closed glottis. Young athletes are at a heightened risk of experiencing this complication because they can develop intensely negative intrathoracic pressures. Given the limited treatment options available, it is crucial to prevent this phenomenon and to promptly identify it if present. Given its rarity and relative obscurity, the authors hope to raise the awareness for this phenomenon. It is a condition that any medical professional (internists, surgeons, anesthesiologists, intensivists) may encounter in his or her practice.
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