The sudden removal of the PEEP leads to interstitial fluid transudation and pulmonary edema. POPE II is much less commonly reported than POPE I and predictive factors have not been clearly elucidated. Diagnosis POPE requires rapid intervention and may be confused with other causes of postoperative respiratory distress. Although symptoms usually develop within one hour of the precipitating event, delayed onsets have been reported. The presence of agitation, tachypnea, tachycardia, frothy pink pulmonary secretions, rales and progressive oxygen desaturation suggests the diagnosis of POPE in the appropriate setting.
Chest radiograph findings of pulmonary edema support the diagnosis.
The absence of gastric contents in pulmonary secretions, a history of normal cardiac function and, particularly, the occurrence of such symptoms in a vigorous young person makes the diagnosis of POPE more likely. After anesthesia After cardiopulmonary bypass Reprinted with permission from Braunwald E, et al. Clinical aspects of heart failure. Prognosis and Treatment Treatment of postobstructive pulmonary edema consists of supplemental oxygen and support, usually including intubation and low levels of positive end-expiratory pressure. Most cases of POPE respond promptly to appropriate treatment.