Unilateral Re-expansion Pulmonary Edema Research Articles

Robotic‐assisted cardiac surgery without lung isolation utilizing single‐lumen endotracheal tube intubation

This study assessed the feasibility and outcomes of performing robotic cardiac surgery without lung isolation using single-lumen (SL) endotracheal tube intubation. Between 2013 and 2017, 132 patients underwent robotically-assisted atrial septal defect closure. A retrospective analysis was performed of 23 patients (11 males, mean age 30.9 ± 5 years) who underwent robotic surgery with double-lumen (DL) endotracheal tube intubation (group 1) compared with 109 patients (57 males, mean age 32.4 ± 7.5 years) undergoing the same procedure with SL endotracheal intubation (group 2). The patient groups were compared in terms of demographic characteristics, operative data, and complications. The technical feasibility of the robotic procedure without lung isolation was evaluated. There were no mortality, intraoperative complication, and conversion. Mean total anesthesia time was significantly decreased in the SL intubation group (238.3 ± 22.4 vs 227.2 ± 21.2 minutes; P = .025). First-pass intubation success was significantly higher in the SL intubation group (17 [73.9%] vs 98 [89.9%] patients; P = .032). Mean ventilation time (10.9 ± 5.3 hours), intensive care unit stay (16.8 ± 10.1 hours), and the length of hospital stay (3.8 ± 1.2 days) was significantly decreased in patients with SL tube (P < .05). Unilateral reexpansion pulmonary edema was observed in five (21.7%) patients with DL tube, whereas no patient with SL tube had this complication. SL endotracheal tube intubation without lung isolation is a feasible and safe airway alternative in robotic cardiac procedures. This approach resulted in shorter anesthesia time, ventilation time and the length of hospital stay. Port placement and robotic set-up can be uneventfully performed without lung isolation.

UNILATERAL REEXPANSION PULMONARY EDEMA AFTER TUBE THORACOSTOMY: A CASE REPORT

We report a case of unilateral reexpansion pulmonary edema (RPE) in a patient of secondary spontaneous pneumothorax of 2 days

Prevention of Pulmonary Edema after Minimally Invasive Cardiac Surgery with Mini-Thoracotomy Using Neutrophil Elastase Inhibitor.

Unilateral re-expansion pulmonary edema (RPE) is a rare but one of the most critical complications that may occur after re-expansion of a collapsed lung after minimally invasive cardiac surgery (MICS) with mini-thoracotomy. We performed a total of 40 consecutive patients with MICS by right mini-thoracotomy with single-lung ventilation between January 2013 and June 2016. We divided the patients into control group (n = 13) and neutrophil elastase inhibitor group (n = 27). Neutrophil elastase inhibitor group received continuous intravenous infusion of neutrophil elastase inhibitor at 0.2-0.25 mg/kg per hour from the start of anesthesia until extubation during the perioperative period. There were no relations with operative time, cardiopulmonary bypass (CPB) time, aortic clamp time, and intraoperative water valances for postoperative mechanical ventilation support time. Compared with the neutrophil elastase inhibitor group, the control group had significantly higher initial alveolar-arterial oxygen gradient and significantly lower initial ratio of partial pressure of arterial oxygen to fraction of inspired oxygen at the intensive care unit (ICU). The control group had significantly longer postoperative mechanical ventilation support time and hospital stay compared with the neutrophil elastase inhibitor group. Neutrophil elastase inhibitor may have beneficial effects against RPE after MICS with mini-thoracotomy.

Unilateral re-expansion pulmonary edema following drainage of spontaneous massive pneumothorax of short duration

Re-expansion pulmonary edema (RPE) is a rare complication of thoracentesis. Mortality has been reported in 20% of cases. We present a 25-year-old male with 2 days history of right sided chest pain with imaging suggestive of right-sided extensive pneumothorax. Patient developed symptoms consistent with RPE 12 h after placement of intercostal tube which was documented by imaging. Patient received symptomatic management in respiratory care ward with improvement of his symptoms within 24 h and normalization of chest X-ray after 3 days.

Successful management of severe unilateral re-expansion pulmonary edema after mitral valve repair with mini-thoracotomy using extracorporeal membrane oxygenation

A 60-year-old man received mitral valve repair via right mini-thoracotomy, which was followed by unilateral re-expansion pulmonary edema on the right side and severe hemoptysis just after the surgery. Despite differential lung ventilation with unilateral high positive end expiratory pressure was initiated for the affected right lung, respiratory function did not improved and hemodynamics was collapsed in the next day. Veno-venous extracorporeal membrane oxygenation was initiated by cannulation of the right jugular and the left femoral vein. After pulmonary function recovered gradually, veno-venous extracorporeal membrane oxygenation was terminated on the fifth postoperative day. He was discharged in ambulatory condition on postoperative day 52.

Unilateral Re-Expansion Pulmonary Edema following Treatment of Pneumothorax with Exceptionally Massive Sputum Production, followed by Circulatory Collapse

A case of a 61-year-old man who developed ipsilateral re-expansion pulmonary edema after pleural drainage for a right pneumothorax is described. The patient's chest x-ray revealed a totally collapsed right lung. After insertion of a chest drainage tube, he began to produce a moderate amount of serous, yellowish sputum. Despite continuous positive airway pressure support, his dyspnea gradually worsened and his oxygenation could not be maintained; therefore, to improve his hypoxemic state, intubation was necessary. His chest x-ray following chest tube insertion showed ipsilateral diffuse infiltrates. These radiographic and physical findings were consistent with re-expansion pulmonary edema. The present case was complicated by extreme hypotension and tachycardia due to massive fluid loss. His condition gradually improved with invasive mechanical ventilation. Re-expansion pulmonary edema is an uncommon complication of pleural drainage for pneumothorax, and therapy is supportive. In the present case, the exceptional severity of the pulmonary edema, as well as its general concept, is reviewed in accordance with other relevant literature.

Unilateral Re‐Expansion Pulmonary Edema: A Rare Complication Following One‐Lung Ventilation for Minimal Invasive Mitral Valve Reconstruction

A rare case of a unilateral re-expansion pulmonary edema following one-lung ventilation for minimally invasive mitral valve reconstruction in cardiopulmonary bypass is described.

Re-expansion pulmonary edema following video-assisted thoracic surgery for recurrent malignant pleural effusion

A rare case of a unilateral re-expansion pulmonary edema following video-assisted thoracic surgery for malignant pleural effusion is described.

Unilateral Pulmonary Edema Following Surgical Repair Of Diaphragmatic Hernia: A Case Report

Unilateral pulmonary edema may occur after sudden re-expansion of compressed lung which may be due to pneumothorax, pulmonary effusion, tumor, or diaphragmatic hernia (1). We describe in this report a case of unilateral re-expansion pulmonary edema following surgical correction of diaphragmatic hernia.

A Case of Bilateral Reexpansion Pulmonary Edema After Pleurocentesis

Acute bilateral reexpansion pulmonary edema after pleurocentesis is a rare complication. In one case, bilateral reexpansion pulmonary edema after unilateral pleurocentensis in sarcoma was reported. Verious hypotheses regarding the mechanism of reexpansion pulmonary edema include increased capillary permeability due to hypoxic injury, decreased surfactant production, altered pulmonary perfusion and mechanical stretching of the membranes. Ragozzino et al suggested that the mechanism leading to unilateral reexpansion pulmonary edema involves the opposite lung when there is significant contralateral lung compression. Here we report a case of bilateral reexpansion pulmonary edema and acute respiratory distress syndrome after a unilateral pleurocentesis of a large pleural effusion with contralateral lung compression and increased interstitial lung marking underlying chronic liver disease.

Fulminant reexpansion pulmonary edema in a patient with AIDS

A 23-year-old man with AIDS presented to the emergency department with recurrent spontaneous pneumothoraces secondary to recent Pneumocystis carinii pneumonia. Shortly after placement of bilateral pigtail catheters for chest reexpansion, he developed fatal unilateral reexpansion pulmonary edema. The association between P carinii pneumonia and pneumothorax, and the risk factors and pathophysiology of reexpansion pulmonary edema are reviewed. Emergency physicians should recognize that reexpansion pulmonary edema is an important complication in the treatment of prolonged spontaneous pneumothorax that can lead rapidly to severe hypoxia, hypotension, and death.

Reexpansion Pulmonary Edema

Unilateral reexpansion pulmonary edema (RPE) is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. Although RPE generally is believed to occur only when a chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid, in this review 15 of 47 cases of RPE available for assessment occurred when the pulmonary collapse was of short duration or when the lung was reexpanded without suction. The pathogenesis of RPE is unknown and is probably multifactorial. Implicated in the etiological process of RPE are chronicity of collapse, technique of reexpansion, increased pulmonary vascular permeability, airway obstruction, loss of surfactant, and pulmonary artery pressure changes. Since the outcome of RPE was fatal in 11 of 53 cases reviewed (20%), physicians treating lung collapse must be aware of the possible causes and endeavor to prevent the occurrence of this complication.

Hemodynamic and Pulmonary Edema Protein Measurements in a Case of Reexpansion Pulmonary Edema

We describe a patient with unilateral reexpansion pulmonary edema following thoracocentesis of a right pleural effusion. The pulmonary edema-serum total protein ratio was 0.85. Right heart catheterization revealed a normal pulmonary wedge pressure. The pulmonary edema cleared quickly. This is the first case to our knowledge in which pulmonary hemodynamics and lung fluid total protein levels have been monitored in reexpansion pulmonary edema.