흉막박피술 후 중환자실 이송 중 발생한 동측성 재팽창성 폐부종-증례 보고-
Ipsilateral Reexpansion Pulmonary Edema Developed after Decortication-A Case Report-
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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.
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.
참고문헌 (14)
- Cho HY, "A case of reexpansion pulmonary edema following spontaneouspneumothorax", Korean J Med, 43, pp.277~282 (1992)
- 손성동, "흉막삼출액의 관례적 천자 후 발생한 국소성 재팽창성폐 부종 1예", Tuberculosis and Respiratory Diseases, 56(3), pp.297~301 (2004), 대한결핵및호흡기학회
- Jeong SW, "Re-expansion pulmonary edema after chest tubing: a case report", Korean J Crit Care Med, 20, pp.87~91 (2005)
- 정혜경, "흉관 삽관 후 발생한 국소성 재팽창성 폐부종 1예", Tuberculosis and Respiratory Diseases, 67(1), pp.59~62 (2009), 대한결핵및호흡기학회
- Milne B, "Unilateral reexpansion pulmonary edema during emergence from general anesthesia", Anesthesiology, 59, pp.244~245 (1983)
- Desiderio DP, "Intraoperative re-expansion pulmonary edema", Anesthesiology, 67, pp.821~823 (1987)
- Waller DA, "Unilateral pulmonary oedema following the removal of a giant pleural tumour", Thorax, 44, pp.682~683 (1989)
- Rhee SH, "Reexpansion pulmonary edema during decortication operation under general anesthesia - A case report", Korean J Anesthesiol, 22, pp.118~121 (1989)
- Jee DL, "Ipsilateral reexpansion pulmonary edema developed following decortication", Korean J Anesthesiol, 25, pp.1230~1234 (1992)
- Carlson RI, "Pulmonary edema following the rapid reexpansion of a totally collapsed lung due to a pneumothorax: a clinical and experimental study", Surg Forum, 9, pp.367~371 (1958)
- Sohara Y, "Reexpansion pulmonary edema", Ann Thorac Cardiovasc Surg, 14, pp.205~209 (2008)
- Mahfood S, "Reexpansion pulmonary edema", Ann Thorac Surg, 45, pp.340~345 (1988)
- Sewell RW, "Experimental evaluation of reexpansion pulmonary edema", Ann Thorac Surg, 26, pp.126~132 (1978)
- Mahajan VK, "Reexpansion pulmonary edema", Chest, 75, pp.192~194 (1979)