Negative Pressure Pulmonary Oedema after Sedation in a Patient Undergoing Pacemaker Implantation

Abstract

Negative pressure pulmonary oedema (NPPE) is a manifestation of upper airway obstruction and is seen after extubation postoperatively. The large negative intrathoracic pressure generated by forced inspiration against an obstructed airway is thought to be the principal mechanism involved. It is a dangerous and potentially fatal condition with a multifactorial pathogenesis. The Authors report a case of negative pressure pulmonary oedema occurring periprocedurally while undergoing permanent pacemaker implantation under local anaesthesia and light sedation due to upper airway obstruction caused by falling back of the tongue.