BRONCHOSCOPIC FINDINGS IN POSTOBSTRUCTIVE PULMONARY-EDEMA

Purpose: To present the first photographed bronchoscopic findings asso ciated with negative pressure pulmonary oedema (NPPE). Clinical featur es: A previously healthy patient underwent anterior C-3-C-4 disc remov al and arthrodesis. Following tracheal extubation he developed acute r espiratory distress manifested as strider, tachypnoea, restlessness, a nd desaturation. Once the trachea was reintubated, he displayed the cl assic findings of pulmonary oedema. Bronchoscopy was performed to conf irm tracheal tube position and to rule out tracheal injury secondary t o surgical manipulation. Diffuse punctate haemorrhages were noted thro ughout the visualised tracheo-bronchial tree. Conclusion: We believe t hat these haemorrhages represent disruption of the branchial vasculatu re and may contribute to the clinical presentation of NPPE.