Observational studyLung2017
Clinical Features of Patients with Diffuse Alveolar Hemorrhage due to Negative-Pressure Pulmonary Edema.
Observational study in Lung, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 39 citations in OpenAlex.
- Article
- When a Seizure Affects the Lungs: Recurrent Postictal Neurogenic Pulmonary Edema in an Adolescent-A Case Report.Pediatric pulmonology · 2026Article
- Acute post-operative respiratory insufficiency and diffuse alveolar haemorrhage in a young and healthy adult.Breathe (Sheffield, England) · 2025Article
- When the Unexpected Happens: Diffuse Alveolar Hemorrhage in Negative-Pressure Pulmonary Edema.Cureus · 2025Article
- When extubation turns fatal: Delayed hemoptysis from negative pressure pulmonary hemorrhage.Respiratory medicine case reports · 2025Article
- Article
- Negative pressure pulmonary edema (Review).Experimental and therapeutic medicine · 2023Review
- Post-ictal diffuse alveolar haemorrhage: clinical profile based on case reports.Respirology case reports · 2022Article
- Negative-pressure pulmonary Hemorrhaging Due to Severe Obstructive Sleep Apnea.Internal medicine (Tokyo, Japan) · 2021Article
- Diffuse Alveolar Hemorrhage Associated with Dilated Cardiomyopathy and Sleep Apnea Syndrome.Internal medicine (Tokyo, Japan) · 2021Article
- Radiologically and clinically diagnosed acute pulmonary oedema in critically ill patients: prevalence, patient characteristics, treatments and outcomes.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2021Article
- Unilateral pulmonary hemorrhage caused by negative pressure pulmonary edema: A case report.World journal of clinical cases · 2021Article
- Perls' Prussian Blue Stains of Lung Tissue, Bronchoalveolar Lavage, and Sputum.Journal of environmental pathology, toxicology and oncology : official organ of the International Society for Environmental Toxicology and Cancer · 2021Article
- Near-fatal negative pressure pulmonary oedema successfully treated with venovenous extracorporeal membrane oxygenation performed in the hybrid emergency room.BMJ case reports · 2020Article
- Extraordinary Delayed-Onset Negative Pressure Pulmonary Hemorrhage Resulting in Cardiac Arrest after General Anesthesia for Vocal Cord Polypectomy.Case reports in critical care · 2020Article
- Negative pressure pulmonary edema related with severe sleep apnea syndrome: A case report.Respiratory medicine case reports · 2020Article
- Negative pressure pulmonary edema after general anesthesia: A case report and literature review.Medicine · 2019Review
- Diffuse alveolar hemorrhage following sugammadex and remifentanil administration: A case report.Medicine · 2019Article
- Negative pressure pulmonary edema-related diffuse alveolar hemorrhage associated with Sevoflurane and cigarette smoking.Journal of community hospital internal medicine perspectives · 2019Article
- Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDiffuse alveolar hemorrhage (DAH) with negative-pressure pulmonary edema (NPPE) is an uncommon yet life-threatening condition. We aimed at describing the circumstances, clinical, radiological, and bronchoscopic features, as well as the outcome of patients with NPPE-related DAH.
methodsWe performed a retrospective, observational cohort study, using data prospectively collected over 35 years in an intensive care unit (ICU).
resultsOf the 149 patients admitted for DAH, we identified 18 NPPE episodes in 15 patients, one admitted four times for recurrent NPPE-related DAH. The patients were primarily young, male, and athletic. The NPPE setting was postoperative (n = 12/18, 67%) or following generalized tonic-clonic seizures (n = 6/18, 33%). Hemoptysis was almost constant (n = 17/18, 94%), yet rarely massive (>200 cc, n = 1/18, 6%), with anemia observed in 10 (56%) episodes. The DAH triad (hemoptysis, anemia, and pulmonary infiltrates) was observed in 50% of episodes (n = 9/18), and acute respiratory failure in 94% (n = 17/18). Chest computed tomography revealed diffuse bilateral ground glass opacities (n = 10/10, 100%), while bronchoscopy detected bilateral hemorrhage (n = 12/12, 100%) and macroscopically bloody bronchoalveolar lavage, with siderophage absence in most (n = 7/8, 88%), indicating acute DAH. While one episode proved fatal, the other 17 recovered rapidly, with a mean ICU stay lasting 4.6 (2-15) days. Typically, the evolution was rapidly favorable under supportive care.
conclusionNPPE-related DAH is a rare life-threatening condition occurring primarily after tonic-clonic generalized seizure or generalized anesthesia. Clinical circumstances are a key to its diagnosis. Early diagnosis and recognition likely allow for successful management of this potentially serious complication, whereas ictal-DAH appears ominous in epileptic patients.
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