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Ipsilateral Reexpansion Pulmonary Edema Developed after Decortication: A Case Report
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Kyoung Hun Kim, Mi Rang Bang, Myong Su Chon, Jae Hang Shim, Woo Jae Jeon, Sang Yoon Cho, Woo Jong Shin, Jong Hoon Yeom
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Korean J Crit Care Med. 2010;25(4):266-270.
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DOI: https://doi.org/10.4266/kjccm.2010.25.4.266
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 Abstract
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- 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.
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Cardiac Arrest after Aortic Cross Clamping during Surgery for an Abdominal Aortic Aneurysm in a Patient with Coronary Artery Disease and Aortic Regurgitation: A Case Report
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Woo Jae Jeon, Jae Hang Shim, Jin Bum Hong, Kyoung Hun Kim, Sang Yun Cho
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Korean J Crit Care Med. 2009;24(2):111-114.
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DOI: https://doi.org/10.4266/kjccm.2009.24.2.111
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Abstract
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- Patients with chronic aortic regurgitation have a hemodynamically fragile equilibrium; increased afterload during infrarenal aortic cross-clamping and acute decompensation. The tolerance of patients with severe coronary artery disease to the stress of infrarenal aortic cross-clamping differs from patients without overt coronary artery disease. Therefore, careful anesthetic management is needed during infrarenal aortic cross-clamping in patients with aortic regurgitation and coronary artery disease. We describe the anesthetic management of a man with an infrarenal aortic aneurysm that underwent cardiac arrest after aortic-cross clamping for aortoiliac bypass surgery.
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