Negative Pressure Pulmonary Oedema Following Laryngospasm for Potentially Fatal yet Reversible Complication of General Anaesthesia: A Case Report

Abstract

Negative pressure pulmonary oedema (NPPE) is a rare but potentially fatal complication following tracheal intubation and general anaesthesia. We report the case of a 57-year-old male who underwent arthroscopy under general anaesthesia at another hospital. Shortly after extubation, the patient developed acute respiratory distress accompanied by pink frothy secretions and oxygen desaturation. Immediate reintubation was performed, and he was subsequently transferred to our facility, where he was successfully managed with positive pressure mechanical ventilation. NPPE often results from laryngospasm, which induces forceful inspiration against a closed glottis, generating markedly negative intrathoracic pressure and leading to rapid transudation of fluid into the pulmonary interstitium and alveoli. This condition typically manifests within minutes after extubation, and prompt diagnosis with early intervention is essential to prevent morbidity and mortality. In our case, symptoms resolved completely within 24 hours of appropriate ventilatory support. This report highlights the importance of recognising NPPE in the immediate postoperative period and instituting rapid, targeted management to ensure favourable outcomes. In this case, rapid recognition and ventilatory support led to full recovery within 24 hours.