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The authors wish to place on record their appreciation of the interest shown and queries rightly raised by the discerning reader.
As mentioned aspiration was possibily in a patient who was unconscious and had an unprotected airway. The patient was brought to the hospital via Medicare centre in left lateral position within an hour of the incident. In the ICU, the patient had copious pink frothy secretion. She was incubated and mechanical ventilation instituted.
Postoperative pulmonary oedema (POPE) was suspected for the following reasons:
To conclude, though aspiration could have coexisted, our aim in putting up this case report was to highlight the possibility of POPE developing rapidly and without warning following acute airway obstruction. In a series of chest radiographs in children intubated for acute upper airway obstruction, 29 percent developed radiographic evidence of POPE. While these series represent experiences in a tertiary care setting, the surprising frequency of POPE suggests that it is not rare. Rapid recovery can be expected with appropriate management if proper ventilatory and investigative facilities (ABG) are available.