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DOI: 10.1055/a-1931-3761
„Negativdruck-Lungenödem“ und „alveoläre Hämorrhagie“ als Komplikationen einer oberen Atemwegsobstruktion
Negative-pressure pulmonary edema and alveolar hemorrhage are potentially life-threatening complications of upper airway obstructionWidmung
Diesen Artikel widmen wir unserem Lehrer Prof. Dr. Peter Wichert, ehemaliger Direktor der Medizinischen Poliklinik Marburg, zum 87. Geburtstag. Er hat uns für die Physiologie begeistert.
Zusammenfassung
Negativdruck-Lungenödem und alveoläre Hämorrhagie sind lebensbedrohliche Komplikationen infolge einer akuten oberen Atemwegsobstruktion. Durch die Obstruktion im Larynx-/Pharynbereich kommt es zu hohen negativen Intrapleuraldrucken, die sich, durch unterschiedliche Faktoren bedingt, auf die Integrität der alveolo-kapillären Membran auswirken. In der Übersichtsarbeit werden klinische Symptome, Ätiologie, die Pathophysiologie sowie die therapeutischen Optionen beschrieben. Ziel ist es, den Kliniker mit den Krankheitsbildern und den Komplikationen vertraut zu machen.
Abstract
Negative pressure pulmonary edema and alveolar hemorrhage are potentially life-threatening complications after relief of upper airway obstruction. The laryngeal-pharyngeal obstruction results in high negative intrapleural pressures. The increased intrapleural pressures affect the integrity of the alveolo-capillary membrane due to various factors. This review describes clinical symptoms, etiologic factors, pathophysiology and treatment strategies associated with each of these factors. The aim of this review is to equip clinicians with the knowledge base necessary to identify patients at increased risk for negative pressure pulmonary edema and alveolar hemorrhage.
Schlüsselwörter
obere Atemwegsobstruktion - diffuse alveoläre Hämorrhagie - obstruktive Schlafapnoe - Negativdruck - LungenödemKeywords
upper airway obstruction - diffuse alveolar hemorrhage - obstructive sleep apnea - negative pressure - pulmonary edemaPublication History
Received: 01 June 2022
Accepted after revision: 23 August 2022
Article published online:
15 November 2022
© 2022. Thieme. All rights reserved.
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Literatur
- 1 Koehler J, Beutel B, Hildebrandt O. et al. Recurrent Pulmonary Hemorrhages with Hemoptysis as a Result of Vocal Cord Dysfunction (VCD) – An Attempt to Explain. Pneumologie 2021; 75: 1-5
- 2 Lemyze M, Mallat J. Understanding negative pressure pulmonary edema. Intensive Care Med 2014; 40: 1140-1143 DOI: 10.1007/s00134-014-3307-7. (PMID: 24797685)
- 3 Lang SA, Duncan PG, Shephard DA. Pulmonary oedema associated with airway obstruction. Can J Anaest 1990; 37: 210-218
- 4 Bhattacharya M, Kallet RH, Ware LB. et al. Negative-Pressure Pulmonary Edema. Chest 2016; 150: 927-933 DOI: 10.1016/j.chest.2016.03.043. (PMID: 27063348)
- 5 Kulka PJ, Issel R, Wiebalck A. et al. Verzögert auftretendes, postobstruktives Lungenödem. Anaesthesist 2003; 52: 132-136
- 6 Kopp KH. Das postobstruktive Lungenödem als Komplikation einer Endotrachealtubusokklusion. Anaesthesiol Intensivmed Notfallmed Schmerzther 2000; 35: 721-724
- 7 Deepieka K, Kenan CA, Barrocas AM. et al. Negative pressure pulmonary edema after acute upper airway obstruction. J Clin Anesth 1997; 9: 403-408
- 8 Contou D, Voiriot G, Djibre M. et al. Clinical Features of Patients with Diffuse Alveolar Hemorrhage due to Negative-Pressure Pulmonary Edema. Lung 2017; 195: 477-487 DOI: 10.1007/s00408-017-0011-8. (PMID: 28455784)
- 9 Kuramoto K, Matsuyama M, Nonaka M. et al. Negative-pressure pulmonary Hemorrhaging Due to Severe Obstructive Sleep Apnea. Intern Med 2021; 60: 2291-2296 DOI: 10.2169/internalmedicine.6206-20. (PMID: 33612674)
- 10 Bady E, Achkar A, Pascal S. et al. Pulmonary arterial hypertension in patients with sleep apnea syndrome. Thorax 2000; 55: 934-939 DOI: 10.1136/thorax.55.11.934. (PMID: 11050263)
- 11 Osmer C, Al-Oweidi A, Klimek T. Schnarchen und postoperatives Lungenödem. Anaesthesiol Intensivmed Notfallmed Schmerzther 2000; 35: 177-180
- 12 Bacon JL, Fleming C, Marino P. Narrative review of sleep and pulmonary hypertension. J Thorac Dis 2020; 12: 191-201
- 13 Uyar M, Kervancioglu S, Bayram N. et al. Obstructive sleep apnea is the triggering factor for massive hemoptysis. Sleep Breath 2017; 21: 475-478 DOI: 10.1007/s11325-016-1446-5. (PMID: 27995436)
- 14 Ahmed Q, Chung-ParkTomashefski JF. Cardiopulmonary Pathology in Patients with Sleep Apnea/Obesity Hypoventilation Syndrome. Human Pathology 1997; 28: 264-269
- 15 Koehler U, Hildebrandt O, Conradt R. et al. The bronchial arteries – a small but vital contribution to lung perfusion after lung transplantation. Pneumologie 2022; 76: 552-559 DOI: 10.1055/a-1845-0286. (PMID: 35878603)
- 16 Fu Z, Costello L, Tsukimoto K. et al. High lung volume increases stress failure in pulmonary capillaries. J Appl Physiol 1992; 73: 123-133 DOI: 10.1152/jappl.1992.73.1.123. (PMID: 1506359)
- 17 West J. Thoughts on the pulmonary blood-gas barrier. Am J Physiol Lung Cell Mol Physiol 2003; 285: 501-513 DOI: 10.1152/ajplung.00117.2003. (PMID: 12902315)
- 18 West JB. Strength and Failure of Pulmonary CapillariesFutura Publishing Company, Inc Armonk. In: Wagner WW, Weir EK. The Pulmonary Circulation and Gas Exchange. NY: 1994: 1-17
- 19 West JB, Mathieu-Costello O, Jones JH. et al. Stress failure of pulmonary capillaries in racehorses with exercise-induced pulmonary hemorrhage. J Appl Physiol 1993; 75: 1097-1109 DOI: 10.1152/jappl.1993.75.3.1097. (PMID: 8226517)
- 20 West JB, Mathieu-Costello O. High altitude pulmonary edema is caused by stress failure of pulmonary capillaries. Int J Sports Med 1992; 13: 54-58 DOI: 10.1055/s-2007-1024594. (PMID: 1483792)
- 21 West JB. Fragility of pulmonary capillaries. J Appl Physiol 2013; 115: 1-15 DOI: 10.1152/japplphysiol.00229.2013. (PMID: 23640584)
- 22 Poole DC, Erickson HH. Exercise-induced pulmonary hemorrhage: where are we know?. Veterinary Medicine: Research and Reports 2016; 7: 133-148 DOI: 10.2147/VMRR.S120421. (PMID: 30050846)
- 23 Aversa M, Lapinsky SE. Lung physiology at play: Hemoptysis due to underwater hockey. Resp Med Case Rep 2014; 11: 16-17 DOI: 10.1016/j.rmcr.2013.12.002. (PMID: 26029522)
- 24 Evain F, Louge P, Pignel R. et al. Fatal diving: could it be an immersion pulmonary edema? Case report. Intern J Legal Medicine 2022; DOI: 10.1007/s00414-022-02809-x.
- 25 Boussuges A, Pnet C, Thomas P. et al. Haemoptysis after breath-hold diving. Eur Respir J 1999; 13: 697-699
- 26 Willms D, Shure D. Pulmonary Edema due to Upper Airway Obstruction in Adults. Chest 1988; 94: 1090-1092 DOI: 10.1378/chest.94.5.1090. (PMID: 3053060)
- 27 Marchertiene IKA, Macas A, Karbonskiene A. Pulmonary edema and hemorrhage as complications of acute airway obstruction following anaesthesia. Medicina 2008; 44: 871-876
- 28 Freemont RD, Kallet RH, Matthay MA. et al. Postobstructive Pulmonary Edema: A Case for Hydrostatic Mechanisms. Chest 2007; 131: 1742-1746