Post-extubation non-cardiogenic pulmonary edema.

Non-cardiogenic pulmonary edema (NCPE) is a rare entity manifested by pulmonary edema with normal pulmonary arterial pressures. NCPE has been described in children and recently reported in adults. Onset is rapid and late recognition or inappropriate treatment may lead to a fatal outcome. Most adult cases have been attributed to laryngospasm and generation of a large negative intrathoracic pressure causing transcapillary filtration. The majority of reported adult cases were at risk for Upper Airway Obstruction (UAO). This report describes three young, active duty men who developed this entity following routine uncomplicated surgical procedures. Intubations were uncomplicated and fluid management appropriate. No patient had risk factors for UAO. Early extubation with respiratory attempts against a closed glottis may be etiology for this complication.