Pulmonary edema associated with upper airway obstruction
R. K. Kanter and J. F. Watchko
We retrospectively surveyed records of 153 patients with croup or
epiglottitis. Thirty-four children required intubation of the trachea to
relieve upper airway obstruction. In those requiring intubation, pulmonary
edema occurred in four (12%) of 34. Review of 17 previously reported cases,
along with our patients, demonstrated that onset of pulmonary edema due to
upper airway obstruction usually follows intubation. A PaO2 below 50 mm Hg
is observed in 38% and pneumothorax in 24% of all reported cases.
Supplemental oxygen, positive end-expiratory pressure, mechanical
ventilation, and chest tube drainage have prevented death despite these
life-threatening complications.
