Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Aug;40(8):1140-3.
doi: 10.1007/s00134-014-3307-7. Epub 2014 May 6.

Understanding negative pressure pulmonary edema

Malcolm Lemyze  1 , Jihad Mallat
Affiliations

Understanding negative pressure pulmonary edema

Malcolm Lemyze et al. Intensive Care Med. 2014 Aug.
No abstract available

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
As shown in the left part of the illustration, breathing through the normally open upper airway requires minimal diaphragmatic efforts (thin black arrow) that generate small levels (−2 to −8 cmH2O) of negative pleural pressure (P PL) during inspiration. In normal conditions, the alveolar–capillary pressure gradient is small, and when hydrostatic pressures slightly increase in the pulmonary capillary bed, the fluid overload may be offset by increased lymphatic drainage. Conversely, inspiration against an obstructed upper airway—as represented by closed vocal cords in the right side of the illustration—requires forceful diaphragmatic efforts (large black arrow) generating high levels (−50 to −140 cmH2O) of negative P PL that increase venous return to the right side of the heart (large blue arrow). This may result in higher hydrostatic pressures in the pulmonary capillaries and a sudden drop of pressures in the alveolar spaces, creating a huge pressure gradient across the pulmonary capillary wall and disruption of the alveolar–capillary membrane, leading to alveolar flooding and pulmonary edema (yellow arrows)
See this image and copyright information in PMC

References

    1. Tami TA, Chu F, Wildes TO, Kaplan M. Pulmonary edema and acute upper airway obstruction. Laryngoscope. 1986;96:506–509. doi: 10.1288/00005537-198605000-00007. - DOI - PubMed
    1. Fremont RD, Kallet RH, Matthay MA, Ware LB. Postobstructive pulmonary edema: a case for hydrostatic mechanisms. Chest. 2007;131:1742–1746. doi: 10.1378/chest.06-2934. - DOI - PMC - PubMed
    1. Louis PJ, Fernandes R. Negative pressure pulmonary edema. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:4–6. doi: 10.1067/moe.2002.119909. - DOI - PubMed
    1. Matthay MA, Folkesson HG, Clerici C. Lung epithelial fluid transport and the resolution of pulmonary edema. Physiol Rev. 2002;82:569–600. - PubMed
    1. Ware LB, Matthay MA. Clinical practice. Acute pulmonary edema. N Engl J Med. 2005;353:2788–2796. doi: 10.1056/NEJMcp052699. - DOI - PubMed

LinkOut - more resources