Prevalence of Negative-Pressure Pulmonary Edema at an Orthopaedic Hospital

W. Christopher Patton, MD, Champ L. Baker, Jr., MD


J South Orthop Assoc. 2000;9(4) 

In This Article


Fourteen patients (11 male, 3 female) with NPPE involving 11 different surgical procedures were identified over the 15-year period (Table). A total of 16,653 similar procedures were done during this 15-year period. Overall prevalence of NPPE involving those 11 procedures was <0.1%. The prevalence in male patients (0.1%) was not significantly different from the prevalence in female patients (0.05%). The patients who had NPPE (mean age, 28 years; range, 15 to 54 years) were significantly younger than those patients who had similar procedures but did not have NPPE during the same period (mean age, 41 years; range, 5 to 93 years) (P = .002) (Figure). The mean time while under general anesthesia for patients having NPPE was 126 minutes (range, 66 to 260 minutes). The 14 cases of NPPE were distributed among eight orthopaedic surgeons.

Negative-pressure pulmonary edema (NPPE) prevalence in male and female patients for all procedures.

Of the 14 patients, all but 3 responded well to intravenous diuretic and supplemental oxygen therapy alone. The remaining 3 patients were briefly reintubated at the discretion of the anesthesiologist, and signs and symptoms quickly resolved. Only 1 of the 14 patients had a preexisting medical condition (mild hypertension controlled with medication).