The Awareness of Negative Pressure Pulmonary Edema in the Medical Intensive Care Unit

Negative pressure pulmonary edema (NPPE) is a noncardiogenic-related rapid onset of bilateral pulmonary edema secondary to various etiologies that lead to upper airway obstruction. Despite the fact that it is more commonly seen in the emergency department (ED), pediatric intensive care unit (PICU), and the postanesthesia care unit (PACU), there is a lower disease prevalence in the medical intensive care unit (MICU) as it sometimes could be overlooked upon. Prompt treatment often leads to favorable clinical outcomes. We detail a 55-year-old lady with a past medical history of nephrolithiasis, obesity, and obstructive sleep apnea presented with right flank pain due to right kidney subcapsular hematoma and left hydronephrosis due to distal ureteral calculus requiring urological intervention. She unfortunately subsequently developed NPPE requiring MICU level of care after reintubation. Successful extubation was achieved two days later as timely recognition of NPPE led to proper treatment. She was downgraded to general medicine service and discharged without complications.