Ghulam Nabi Lone*, Farooq Ah Ganie, Syed Wahid, Nadeem ul Nazar, Mehmood Ahmad Wani, Mohd Akbar Bhat and Haroon Naqshi
Department of Cardiovascular and Thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences, IndiaFulltext PDF
Background: Reinflation pulmonary edema is a rare but fatal complication with a high mortality following rapid reinflation of a chronically collapsed lung for massive pneumothorax or pleural effusion. Pathophysiology is still unclear but hypoxia induced oxidative stress, ischemic reperfusion injury, inflammatory response and negative intrathoracic pressure are possible mechanisms.
Methods: A prospective analysis of 842 patients with spontaneous pneumothorax/pleural effusion is reported. All the patients have reported to the hospital during the period from August, 1997 to August, 2018. Risk factors were evaluated and clinical profile of patients with re-expansion pulmonary edema was studied.
Results: Six of 842 (71%) patients had developed reinflation pulmonary edema after decompression of spontaneous pneumothorax and pleural effusion. Out of 6 patients 5 had massive spontaneous pneumothorax and 1 had massive pleural effusion. Two of 6 (33.3%) patients died instead of all possible manueres and mechanical ventilation.
Conclusion: Reinflation pulmonary edema should always be considered when in presence of risk factors patient develops hypoxemia after drainage/re-expansion for spontaneous pneumothorax and deteriorates dramatically. Treating surgeons need to be quite aware of this rare entity and take immediate steps to correct it.
Nabi Lone G, Ah Ganie F, Wahid S, ul Nazar N, Ahmad Wani M, Akbar Bhat M, et al. Reinflation Pulmonary Edema Following Decompression of Massive Spontaneous Pneumothorax/ Pleural Effusion: A Rare but Avoidable Catastrophe. Ann Thorac Surg Res. 2019;1(1):1002.