Meeker Jared W, Jaeger Amy L, Tillis William P
Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
Illinois Lung & Critical Care Institute, OSF Saint Francis Medical Center, Peoria, IL, USA;
J Community Hosp Intern Med Perspect. 2016 Jul 6;6(3):32257. doi: 10.3402/jchimp.v6.32257. eCollection 2016.
Reexpansion pulmonary edema (RPE) is a rare complication that can occur after rapid reinflation of the lung following thoracentesis of a pleural effusion or chest tube drainage of pneumothorax. The severity in clinical presentation can be widely varied from radiographic changes only to rapidly progressive respiratory failure requiring mechanical ventilation. The quick nature of onset and potential for serious decline in a previously stable patient makes it important to prepare, recognize, diagnose, and appropriately manage patients who develop RPE. The standard treatment for RPE consists of supportive care, and there are certain measures that may be taken to reduce the risk, including limiting the amount drained and avoiding excessive negative pleural pressure. Exactly how to prevent RPE remains unclear, however, and varying recommendations exist. This is a case report of RPE after thoracentesis for a pleural effusion and a brief review of literature to date, including potential preventative strategies.
复张性肺水肿（RPE）是一种罕见的并发症，可发生于胸腔穿刺抽液或胸腔闭式引流治疗气胸后肺快速复张时。临床表现的严重程度差异很大，从仅出现影像学改变到迅速进展为需要机械通气的呼吸衰竭。其起病迅速，且能使原本病情稳定的患者病情严重恶化，因此，对于发生RPE的患者，做好准备、识别、诊断及恰当处理非常重要。RPE的标准治疗包括支持治疗，还可采取某些措施降低风险，如限制引流量及避免胸膜腔负压过大。然而，如何确切预防RPE仍不明确，且存在不同的建议。本文报告1例胸腔穿刺抽液后发生RPE的病例，并对目前的文献进行简要综述，包括潜在的预防策略。
