Non cardiogenic pulmonary edema as consequence of upper airway obstruction

Abstract

Non cardiogenic pulmonary edema is a rare complication of upper airway obstruction. Its etiology is controversial, but probably can be explained by the Starling's law, when the large negative intrathoracic pressure generated exceeds the intravascular and interstitial pressures, shifting fluids from capillaries to interstitium and alveoli. In addition, alteration of capillary permeability potentiates fluid migration. We present herein, a case of non cardiogenic pulmonary edema following relief of upper airway obstruction in a 14 years old girl underwent surgical repair of cleft palate. Cardiogenic pulmonary edema could be excluded by a normal CVP, wedge pressure and four chamber echocardiography. The edema fluid: plasma protein ratio greater than 0.7 can indicate an increased capillary permeability. Mendelson's syndrome could be ruled out by the rapid improvement seen and the soft clinical course.