Postobstructive pulmonary edema in the setting of aspiration and air travel

Kellen T. Galster, Lisa D Mills, Fernando R. Silva

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Postobstructive pulmonary edema (POPE) - also referred to as negative pressure pulmonary edema - occurs with deep inspiration against a closed glottis or obstructed airway. The result can be life threatening, however, most cases have a self-limited presentation and resolve with supportive care.

Objective Our aim was to critically evaluate a previously unreported mechanism in the exacerbation of POPE.

Case Report This is a report of a 50-year-old woman who experienced an acute episode of hypoxia and altered mental status aboard a transcontinental flight. Her presentation was suggestive of pulmonary embolus. However, a detailed history yielded an episode of preflight choking relieved by the Heimlich maneuver. After 2 days of supportive care she was discharged with a complete return to baseline.

Conclusions Subclinical cases of POPE can be exacerbated by the low atmospheric pressure experienced on commercial airlines. With early recognition and supportive treatment, the patient returned to baseline before her discharge 2 days later. Making the diagnoses of POPE is not always straightforward for the practitioner and necessitates a broad differential. Initial supportive care focusing on maximizing respiratory support is critical.

Original languageEnglish (US)
Pages (from-to)e143-e146
JournalJournal of Emergency Medicine
Volume47
Issue number6
DOIs
StatePublished - Dec 1 2014

Fingerprint

Air Travel
Pulmonary Edema
Heimlich Maneuver
Glottis
Atmospheric Pressure
Airway Obstruction
Embolism
History
Pressure
Lung

Keywords

  • acute obstruction
  • aspiration
  • case report
  • Heimlich maneuver
  • NPPE
  • POPE
  • postobstructive pulmonary edema
  • pulmonary edema

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Postobstructive pulmonary edema in the setting of aspiration and air travel. / Galster, Kellen T.; Mills, Lisa D; Silva, Fernando R.

In: Journal of Emergency Medicine, Vol. 47, No. 6, 01.12.2014, p. e143-e146.

Research output: Contribution to journalArticle

Galster, Kellen T. ; Mills, Lisa D ; Silva, Fernando R. / Postobstructive pulmonary edema in the setting of aspiration and air travel. In: Journal of Emergency Medicine. 2014 ; Vol. 47, No. 6. pp. e143-e146.
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