Korean J Anesthesiol.  2006 Jan;50(1):103-107. 10.4097/kjae.2006.50.1.103.

Reexpansion Pulmonary Edema Occurred after Evacuating the Hepatic Hydrothorax in a Liver Transplant Patient: A case report

• Yang M
• Kim HJ
• Heo JS
• Kim GS

• KMID: 2237486
• DOI: http://doi.org/10.4097/kjae.2006.50.1.103

Abstract

A hepatic hydrothorax is a pleural effusion that develops in patients with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. It is a complication of end-stage liver disease, and a liver transplant is the treatment of choice. In our case, a reexpansion pulmonary edema occurred after evacuating 4,250 ml of ascites and aspirating 3,600 ml of the pleural effusion within 15 minutes aimed at visually improving the surgical field in a 46-year-old male patient receiving a liver transplant. 1 hour 30 minutes after aspirating the pleural effusion, the level of oxygen saturation decreased from 100% to 95%, and serosanguinous fluid spilled over from the endotracheal tube. We inserted a double lumen endotracheal tube to both separate and protect the unaffected left lung, and applied CPAP 10 cmH2O at the affected right lung. The reexpansion pulmonary edema was successfully treated using this supportive management.

Keyword

double lumen endotracheal tube; hepatic hydrothorax; liver transplantation; reexpansion pulmonary edema

MeSH Terms

Ascites
Fibrosis
Humans
Hydrothorax*
Hypertension, Portal
Liver Diseases
Liver Transplantation
Liver*
Lung
Male
Middle Aged
Oxygen
Pleural Effusion
Pulmonary Edema*
Oxygen