Korean J Crit Care Med.  2010 Dec;25(4):266-270. 10.4266/kjccm.2010.25.4.266.

Ipsilateral Reexpansion Pulmonary Edema Developed after Decortication: A Case Report

• Kim KH
• Bang MR
• Chon MS
• Shim JH
• Jeon WJ
• Cho SY
• Shin WJ
• Yeom JH

• KMID: 2228192
• DOI: http://doi.org/10.4266/kjccm.2010.25.4.266

Abstract

Reexpansion pulmonary edema (RPE) is a rare but sometimes fatal complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. We experienced a case of RPE that developed following decortication. A 46 year-old female had a decortication for pyothorax under one-lung anesthesia. There was no event during the operation and results of arterial blood gas analysis were within normal limits. After the operation, tracheal extubation was performed and 100% oxygen saturation on a pulse oximeter (SpO2) was maintained with 100% O2, (8 L/min) via mask ventilation with self-respiration. The patient, with 50% Venturi mask, was transported to the intensive care unit (ICU). On arrival at the ICU, a SpO2 of 80% was detected and arterial blood gas analysis revealed hypoxemia with acute hypercapnic respiratory acidosis. Fortunately, reexpansion pulmonary edema was detected early and intensive treatment was performed using mechanical ventilation with positive end-expiratory pressure. Tracheal extubation was performed after 1 day of mechanical ventilation. The reexpansion pulmonary edema was successfully treated and the patient recovered without any complications.

Keyword

decortication; pyothorax; reexpansion pulmonary edema

MeSH Terms

Acidosis, Respiratory
Airway Extubation
Anesthesia
Anoxia
Blood Gas Analysis
Empyema, Pleural
Female
Humans
Intensive Care Units
Masks
Oxygen
Pleural Effusion
Pneumothorax
Positive-Pressure Respiration
Pulmonary Atelectasis
Pulmonary Edema
Respiration, Artificial
Ventilation
Oxygen