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Initial airway manoeuvres and face-mask ventilation with 100% oxygen against high airway resistance provided only transient improvement, requiring tracheal re-intubation and positive-pressure ventilation. Following subsequent uneventful tracheal extubation, he developed recurrent respiratory distress in the post-anaesthesia care unit, characterised by biphasic stridor, bilateral crackles and scant frothy secretions. As cardiogenic causes were excluded by transthoracic echocardiography, the clinical presentation was consistent with negative-pressure pulmonary oedema. Supportive management, including supplemental oxygen, careful fluid balance and diuretic therapy under close monitoring, resulted in progressive clinical improvement. The patient made a full recovery and was discharged 24 hours postoperatively.<\/jats:p>","DOI":"10.1136\/bcr-2025-269379","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:05:13Z","timestamp":1787655913000},"page":"e269379","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Negative-pressure pulmonary oedema following upper airway obstruction after tracheal extubation in an adolescent undergoing general anaesthesia for dental extractions"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-0681","authenticated-orcid":false,"given":"Carla","family":"Retroz-Marques","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, ULS Coimbra, Coimbra, Coimbra District, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5521-9558","authenticated-orcid":false,"given":"Diogo","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, ULS Coimbra, Coimbra, Coimbra District, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9442-825X","authenticated-orcid":false,"given":"In\u00eas Retroz","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of General Surgery, ULS de Santo Ant\u00f3nio, Porto, Porto District, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Acilio","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, ULS Coimbra, Coimbra, Coimbra District, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"2026091107252256000_19.8.e269379.1","doi-asserted-by":"crossref","unstructured":"Liu R , Wang J , Zhao G , et al . 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