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Negative-pressure pulmonary edema accompanied by hemorrhage as a manifestation of upper airway obstruction during extubation is an uncommon problem that is potentially life-threatening.This is not uncommon after OSA surgery.
The pathophysiological mechanism involved is the generation of markedly negative intrathoracic pressure, which leads to an increase in pulmonary vascular volume and pulmonary capillary transmural pressure, creating a risk of disruption of the alveolar-capillary membrane.
Dr.Thomas, the senior anesthetist share his experience of this fatal condition during sleep apnea surgery.