Acute and Critical Care

Case Reports

Ipsilateral Reexpansion Pulmonary Edema Developed after Decortication: A Case Report: Kyoung Hun Kim, Mi Rang Bang, Myong Su Chon, Jae Hang Shim, Woo Jae Jeon, Sang Yoon Cho, Woo Jong Shin, Jong Hoon Yeom; Korean J Crit Care Med. 2010;25(4):266-270.; DOI: https://doi.org/10.4266/kjccm.2010.25.4.266

Abstract PDF: 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.

Reexpansion Pulmonary Edema Following the Early Decompression of Pneumothorax Occurred after Anesthetic Induction in a Patient with Lung Bulla: A Case Report: Hye Jin Jeung, Hyun Jung Lee, Seok Jai Kim, Sang Hyun Kwak; Korean J Crit Care Med. 2010;25(3):159-162.; DOI: https://doi.org/10.4266/kjccm.2010.25.3.159

Abstract PDF: When a rapidly re-expanding lung has been in a state of collapse for more than several days, pulmonary edema sometimes occurs. This is called reexpansion pulmonary edema. In general, it most commonly occurs in patients with a large pneumothorax of long duration. In this case, a 15 year old female patient with a 2.3 cm sized bulla in the right lung developed right pneumothorax after anesthetic induction. Although early drainage by closed thoracostomy was performed, right pulmonary edema eventually occurred. It is unusual that vigorous reexpansion pulmonary edema developed even though early decompression was performed within one hour after development of pneumothorax.

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