Limits...
Reexpansion pulmonary edema after chest drainage for pneumothorax: A case report and literature overview.

Verhagen M, van Buijtenen JM, Geeraedts LM - Respir Med Case Rep (2014)

Bottom Line: Shortly afterwards he developed reexpansion pulmonary edema and was transferred to the intensive care unit for ventilatory support.RPE is characterized by rapidly progressive respiratory failure and tachycardia after intercostal chest drainage.Early recognition of signs and symptoms of RPE is important to initiate early management and allow for a favorable outcome.

View Article: PubMed Central - PubMed

Affiliation: VU Medical Center, Amsterdam, Department of Traumasurgery, The Netherlands.

ABSTRACT

Background: Reexpansion pulmonary edema (RPE) is a rare complication that may occur after treatment of lung collapse caused by pneumothorax, atelectasis or pleural effusion and can be fatal in 20% of cases. The pathogenesis of RPE is probably related to histological changes of the lung parenchyma and reperfusion-damage by free radicals leading to an increased vascular permeability. RPE is often self-limiting and treatment is supportive.

Case report: A 76-year-old patient was treated by intercostal drainage for a traumatic pneumothorax. Shortly afterwards he developed reexpansion pulmonary edema and was transferred to the intensive care unit for ventilatory support. Gradually, the edema and dyspnea diminished and the patient could be discharged in good clinical condition.

Conclusion: RPE is characterized by rapidly progressive respiratory failure and tachycardia after intercostal chest drainage. Early recognition of signs and symptoms of RPE is important to initiate early management and allow for a favorable outcome.

No MeSH data available.


Related in: MedlinePlus

Complete left-sided pneumothorax, costa 7 fracture.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4356048&req=5

fig1: Complete left-sided pneumothorax, costa 7 fracture.

Mentions: A 76-year-old male patient suffering from Alzheimer's and Parkinson's disease had difficulties walking and was admitted to the neurology ward because of frequent falls. Two days after admission, the patient was delirious and fell out of bed again. The neurological resident who examined the patient found absent breathing sounds on the left hemi thorax. A chest X-ray showed a complete left-sided pneumothorax and a single, non-dislocated fracture of the seventh rib (Fig. 1). An intercostal drainage tube (ICD) was inserted and 350 mL of serosanguineous fluid was instantly drained whilst suction of 15 cm H2O was applied. A second chest X-ray showed a fully re-expanded left lung (Fig. 2) and oxygen saturation was 100% with 2 L of oxygen. However, 2 h after the insertion of the ICD, the patient became severely dyspneic and his oxygen saturation level dropped to 66%. Neither severe blood loss, air leakages from the ICD or serum abnormalities (Hb, Leucocytes) were observed.


Reexpansion pulmonary edema after chest drainage for pneumothorax: A case report and literature overview.

Verhagen M, van Buijtenen JM, Geeraedts LM - Respir Med Case Rep (2014)

Complete left-sided pneumothorax, costa 7 fracture.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356048&req=5

fig1: Complete left-sided pneumothorax, costa 7 fracture.
Mentions: A 76-year-old male patient suffering from Alzheimer's and Parkinson's disease had difficulties walking and was admitted to the neurology ward because of frequent falls. Two days after admission, the patient was delirious and fell out of bed again. The neurological resident who examined the patient found absent breathing sounds on the left hemi thorax. A chest X-ray showed a complete left-sided pneumothorax and a single, non-dislocated fracture of the seventh rib (Fig. 1). An intercostal drainage tube (ICD) was inserted and 350 mL of serosanguineous fluid was instantly drained whilst suction of 15 cm H2O was applied. A second chest X-ray showed a fully re-expanded left lung (Fig. 2) and oxygen saturation was 100% with 2 L of oxygen. However, 2 h after the insertion of the ICD, the patient became severely dyspneic and his oxygen saturation level dropped to 66%. Neither severe blood loss, air leakages from the ICD or serum abnormalities (Hb, Leucocytes) were observed.

Bottom Line: Shortly afterwards he developed reexpansion pulmonary edema and was transferred to the intensive care unit for ventilatory support.RPE is characterized by rapidly progressive respiratory failure and tachycardia after intercostal chest drainage.Early recognition of signs and symptoms of RPE is important to initiate early management and allow for a favorable outcome.

View Article: PubMed Central - PubMed

Affiliation: VU Medical Center, Amsterdam, Department of Traumasurgery, The Netherlands.

ABSTRACT

Background: Reexpansion pulmonary edema (RPE) is a rare complication that may occur after treatment of lung collapse caused by pneumothorax, atelectasis or pleural effusion and can be fatal in 20% of cases. The pathogenesis of RPE is probably related to histological changes of the lung parenchyma and reperfusion-damage by free radicals leading to an increased vascular permeability. RPE is often self-limiting and treatment is supportive.

Case report: A 76-year-old patient was treated by intercostal drainage for a traumatic pneumothorax. Shortly afterwards he developed reexpansion pulmonary edema and was transferred to the intensive care unit for ventilatory support. Gradually, the edema and dyspnea diminished and the patient could be discharged in good clinical condition.

Conclusion: RPE is characterized by rapidly progressive respiratory failure and tachycardia after intercostal chest drainage. Early recognition of signs and symptoms of RPE is important to initiate early management and allow for a favorable outcome.

No MeSH data available.


Related in: MedlinePlus