PMC6325615_01
Chest radiographic images of a fourteen year-old patient.. Onset of pulmonary edema at hour 0 (panel
a) and progress at hour 10 (panel
c), hour 17 (panel
d) and resolution of post obstructive pulmonary edema at hour 37 (panel
e). Intraoperative bronchoscopy at hour 1.5 showing pulmonary edema (panel
b).
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Chest x-ray (CXR) revealed bilateral pulmonary edema ( Figure 1a).  An intraoperative bronchoscopy demonstrated pink frothy secretions consistent with pulmonary edema distal to the endotracheal tube, with no evidence of aspiration or frank blood in the airways ( Figure 1b). Over the next 12 hours the HFOV ventilator settings were titrated down as serial CXRs showed improvement ( Figure 1c and 1d). She was extubated to CPAP (8 cmH 2O) 12 hours later and her CXR showed improvement of lung injury ( Figure 1e).