NPPE or not?

Melody · medicine forum beginner Joined: 30 Apr 2005 Posts: 5

On awakening after orthopaedic surgery, a healthy 34 y/o male patient is
suspected of biting his endotracheal tube for 5-10 seconds. Bloody froth is
observed within seconds of the apparent bite. Pulmonary edema eventually
sets in.

Question #1: Can a 5-10 second bite on an 8.0 endotracheal tube, without any
other contributing cause, trigger negative pressure pulmonary edema?

Question #2: Is the immediate appearance of a bloody froth consistent (or
possible) with NPPE given the supposed obstruction from the suspected bite?

Question #3: Was this really a NPPE?

Guest · Posted: Tue May 03, 2005 5:12 pm Post subject: Re: NPPE or not?

Saw something not too unlike this recently - a patient was extubated
with swollen cords (bad judgment call by the residents) - had clear
stridor with visible retractions, was luckily and easily reintubated,
and demonstrated a transient bloody frothy phenomenon like the one you
describe... so I guess it could happen. Question for a pulmonologist, I
guess.

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