Pulmonary edema secondary to chronic upper airway obstruction. Hemodynamic study in a child |
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Authors: | S Sofer R Baer Y Gussarsky A Lieberman J Bar-Ziv |
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Institution: | (1) Pediatric Intensive Care Unit, Soroka Medical Center, Beer-Sheba, Israel;(2) Department of Anesthesia, Soroka Medical Center, Beer-Sheba, Israel;(3) Department of Cardiology, Soroka Medical Center, Beer-Sheba, Israel;(4) Department of Otolaryngology, Soroka Medical Center, Beer-Sheba, Israel;(5) Department of Pediatric Radiology, Soroka Medical Center, Beer-Sheba, Israel;(6) Faculty of Health, Ben-Gurion University of the Negev, Beer-Sheba, Israel |
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Abstract: | A 22-month-old girl with the syndrome of hypoventilation, pulmonary hypertension, cor pulmonale and pulmonary edema due to adenoidal hypertrophy is described. Adenoidectomy resulted in relief of all symptoms and signs within 24 h. Hemodynamic study using pulmonary artery catheter showed that the pulmonary artery pressure returned to normal 48 h after relief of the obstruction. The normal left ventricular end-diastolic pressure, measured throughout the period of obstruction, in the presence of severe pulmonary edema, could suggest a non-cardiogenic low pressure pulmonary edema. However, the highly negative pleural pressure which existed during upper airway obstruction indicated an elevation of transmural left ventricular end diastolic pressure (compared to pulmonary wedge pressure) and thus, suggested that the pulmonary edema in this syndrome is secondary to both — right and left heart failure. |
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Keywords: | Hypoventilation Pulmonary hypertension Cor pulmonale Pulmonary edema Upper airway obstruction |
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