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Canadian Journal of Anesthesia 47:176-178 (2000)
© Canadian Anesthesiologists' Society, 2000
Clinical Report

Biting the laryngeal mask : an unusual cause of negative pressure pulmonary edema

Jean-Michel Devys, MD, Christine Balleau, MD, Christian Jayr, MD and Jean-Louis Bourgain, MD

From the Département d'Anesthésie, Institut Gustave Roussy, 68, Rue Camille Desmoulins, 94805 Villejuif cedex, France.

Dr Jean-Michel Devys, Département d'Anesthésie, Hôpital Robert Debré, 48, Boulevard Serurier, 75 019 Paris, France. Phone: 33-1-42-11-44-37; Fax: 33-1-42-11-52-09.

Objectif : Décrire un oedème pulmonaire à pression négative causé par la morsure du tube du masque laryngé (ML) au réveil de l'anesthésie générale.

Éléments cliniques : Un patient en santé a subi une anesthésie générale avec ML et ventilation artificielle. Pendant la récupération, il a fortement mordu le ML et a énergiquement tenté d'inspirer jusqu'au retrait du masque. Cinq minutes plus tard, il a développé une dyspnée et a présenté une hémoptysie de 50 ml de sang frais. La radiographie pulmonaire a montré des infiltrats alvéolaires bilatéraux. L'examen pharyngo-laryngé était normal. La bronchoscopie n'a révélé aucune lésion, mais des sérosités diffuses, rosées et spumeuses. L'examen clinique et la radiographie pulmonaire étaient normaux après 12 h d'oxygénothérapie nasale, confirmant ainsi l'obstruction des voies aériennes comme cause la plus probable de cet oedème pulmonaire.

Conclusion : L'obstruction des voies aériennes causée par une morsure du tube du masque laryngé peut causer un oedème pulmonaire à pression négative.




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This Article
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