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X - Pulmonary edema - ALI/ARDS

Negative pressure pulmonary edema (NPPE)

Last update 17/06/2026

See also under negative pressure pulmonary hemorrhage IIIf. (Fr: OAP par obstruction des VAS et pression négative inspiratoire). NPPE develops as an rapid-onset consequence of large negative intrathoracic pressure swings against a closed airway. Tracheal petechiae have been noted in some cases: PMID 21362660. Common causes include tonsillar enlargement/surgery, obstruction of the upper/large airway, angioedema, recent extubation, thyroid conditions, vocal cord surgery. Pathophysiology at PMID 23640584. Review at PMID 25445940

Causative drugs

Frequency - Incidence

Incidence of cardiac adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for cardiac adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

Electroconvulsive therapy

Lidocaine (lignocaine, xylocaine)

Naloxone

Sugammadex