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 language | English (US) |
|---|---|
| Pages (from-to) | e143-e146 |
| Journal | Journal of Emergency Medicine |
| Volume | 47 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 1 2014 |
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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 journal › Article
}
TY - JOUR
T1 - Postobstructive pulmonary edema in the setting of aspiration and air travel
AU - Galster, Kellen T.
AU - Mills, Lisa D
AU - Silva, Fernando R.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - 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.
AB - 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.
KW - acute obstruction
KW - aspiration
KW - case report
KW - Heimlich maneuver
KW - NPPE
KW - POPE
KW - postobstructive pulmonary edema
KW - pulmonary edema
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UR - http://www.scopus.com/inward/citedby.url?scp=84916881813&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2014.07.054
DO - 10.1016/j.jemermed.2014.07.054
M3 - Article
C2 - 25281173
AN - SCOPUS:84916881813
VL - 47
SP - e143-e146
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
SN - 0736-4679
IS - 6
ER -