Unexpected pulmonary edema and cardiac arrest following wedge resection of spontaneous pneumothorax -A case report.

Anesthesia and pain medicine Pub Date : 2022-07-01 Epub Date: 2022-06-17 DOI:10.17085/apm.21116
Woong Han, Gyu Seong Kim, Jong Min Lee, Chang Mook Lim, Hong Seuk Yang, Chang Yeong Jeong, Dong Ho Park
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Abstract

Background: Reexpansion pulmonary edema is a rare but potentially lethal complication. We report a case of suspected reexpansion pulmonary edema that led to cardiac arrest.

Case: A 16-year-old male patient underwent wedge resection due to right pneumothorax. The patient showed pink frothy sputum three hours following surgery, and a chest x-ray showed right unilateral pulmonary edema. Thirteen hours following surgery, the patient continuously showed pink frothy sputum and presented with severe hypoxemia, tachypnea, and tachycardia. After transferring to the intensive care unit (ICU), he developed ventricular tachycardia. Cardiopulmonary resuscitation was performed for 32 min. Chest X-ray showed diffuse bilateral pulmonary edema. Extracorporeal membrane oxygenation was performed. During the 65 days of ICU care, the patient became mentally alert. However, follow-up echocardiography revealed severe heart failure.

Conclusions: Rexpansion pulmonary edema can rapidly progress to diffuse bilateral pulmonary edema. Therefore, careful observation is required for the patients who show signs of pulmonary edema after reexpansion.

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自发性气胸楔形切除术后意外肺水肿及心脏骤停1例。
背景:再扩张性肺水肿是一种罕见但潜在致命的并发症。我们报告一例疑似再扩张肺水肿导致心脏骤停。病例:一位16岁男性患者因右侧气胸行楔形切除术。术后3小时患者出现粉红色泡沫痰,胸部x线片显示右侧单侧肺水肿。术后13小时,患者持续出现粉红色痰泡,并出现严重低氧血症、呼吸急促、心动过速。转入重症监护室(ICU)后,他出现室性心动过速。心肺复苏32分钟。胸片示双侧弥漫性肺水肿。体外膜氧合。在ICU护理的65天中,患者的精神变得清醒。然而,随访超声心动图显示严重的心力衰竭。结论:扩张性肺水肿可迅速发展为弥漫性双侧肺水肿。因此,对于再扩张后有肺水肿征象的患者,需要仔细观察。
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