POSTOBSTRUCTIVE PULMONARY-EDEMA INDUCED BY ENDOTRACHEAL-TUBE OCCLUSION

Pulmonary edema is a well-described complication of upper airway obstr uction, most commonly caused in adults by postanesthetic laryngospasm. The mechanism initiating the formation of postobstructive pulmonary e dema is believed to be the markedly negative intrapleural pressure gen erated by a forceful inspiratory effort against an obstructed extratho racic airway. We herein describe a young, male patient who developed p ulmonary edema postoperatively, upon emergence from anesthesia, after performing repeated, forceful inspiratory maneuvers directed against a n endotracheal tube on which he had bitten down, thereby occluding it. To our knowledge, such an etiology of postobstructive pulmonary edema has not previously been described.