Negative pressure pulmonary oedema in the medical intensive care unit

Intensive Care Med. 2003 Sep;29(9):1601-4. doi: 10.1007/s00134-003-1896-7. Epub 2003 Jul 17.


Objective: Negative pressure pulmonary oedema (NPPE) occurring in the medical intensive care unit (MICU) is an uncommon, probably under-diagnosed, but life-threatening condition.

Design: Retrospective data collection.

Setting: Medical intensive care unit in a 1,500-bedded tertiary care hospital.

Patients and participants: Five patients were diagnosed between January 1998 and January 2002.

Interventions: None.

Measurements and results: Five patients were diagnosed to have NPPE from different aetiologies. These were acute epiglottitis, post-stenting of right bronchus intermedius stenosis, strangulation, compression from a goitre and one patient developed diffuse alveolar haemorrhage after biting the endotracheal tube during recovery from anaesthesia. All patients responded rapidly to supplemental oxygen, positive pressure ventilation and correction of underlying aetiologies. Pulmonary oedema resolved rapidly.

Conclusions: There is a large spectrum of aetiologies causing NPPE in the medical intensive care unit.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Non-Small-Cell Lung / complications
  • Carcinoma, Non-Small-Cell Lung / therapy
  • Critical Care / methods*
  • Epiglottitis / complications
  • Epiglottitis / therapy
  • Esophageal Stenosis / complications
  • Female
  • Goiter / complications
  • Goiter / therapy
  • Humans
  • Intensive Care Units*
  • Intubation, Intratracheal / adverse effects
  • Lung Neoplasms / complications
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Pulmonary Edema / diagnosis*
  • Pulmonary Edema / etiology*
  • Pulmonary Edema / therapy
  • Treatment Outcome