Pulmonary edema complicating upper airway obstruction in infants and children.

The association of pulmonary edema with upper airway obstruction occurs in three clinical settings: acute and chronic upper airway obstruction and immediately after the relief of acute upper airway obstruction. Iatrogenic causes, such as adenotonsillectomy and tracheal intubation, were the most frequently encountered in the authors' series of 21 pediatric patients with such an association. The pathogenesis of this kind of pulmonary edema is multifactorial. The application of moderate continuous positive airway pressure in conjunction with the administration of diuretics rapidly clears pulmonary edema in all three clinical settings, usually within 24 hours, and can probably prevent pulmonary edema immediately after acute obstruction is relieved.