Abstract

Pulmonary edema may be secondary to cardiac or noncardiac etiologies. Noncardiac pulmonary edema develops as a result of increased vasopermeability, leading to water and protein leak into the interstitium. Negative pressure at the level of the alveoli during flexible fiberoptic bronchoscopy (FFB) may lead to the development of pulmonary edema. This is a rare complication in infants undergoing FFB. Dignostic FFB was performed on a four month old female patient with hypoxic ischemic encephalopathy due to persistent upper respiratory findings. Additional respiratory tract anomalies were not observed in this case who was diagnosed as having laryngomalacia. She developed bronchospastic findings following FFB which improved with nebulized salbutamol treatment. Although her bronchospasm regressed two hours after the procedure, oxygen requirement continued and fine rales became prominent on pulmonary auscultation. Findings of pulmonary edema were observed in the chest X-ray. Mannitol at a dose of 0.5 mg/kg was administered with the diagnosis of pulmonary edema. Physical findings and vital signs normalized with treatment and oxygen requirement ceased. This case was discussed because pulmonary edema after FFB is a rare complication and this is the first experience with mannitol in the treatment.