Barril Merino Carlos, Solovera R María E, Bannura Y Felipe, Salas V Patricio
Departamento de Cirugía, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2018 Nov;146(11):1343-1346. doi: 10.4067/S0034-98872018001101343.
Pulmonary expansion edema is a rare complication of the management of primary spontaneous pneumothorax. We report a 20 year old male admitted with a right primary spontaneous pneumothorax. A chest tube connected to a water seal was placed, achieving lung expansion. Immediately, the patient presented hypotension and a reduction in arterial oxygen saturation to 78%. Non-invasive ventilation was started. A chest X ray showed extensive right lung edema. The patient was managed with noradrenaline and albumin infusion with good response. Pulmonary edema resolved on day 3 but air leak was persistant so, the patient required surgery to excise apical bullae in the right lung. He was discharged during the following days in good condition.
肺复张性肺水肿是原发性自发性气胸治疗过程中一种罕见的并发症。我们报告一名20岁男性因右侧原发性自发性气胸入院。置入一根连接水封瓶的胸管,实现了肺复张。随即,患者出现低血压,动脉血氧饱和度降至78%。开始无创通气。胸部X线显示右侧肺广泛水肿。患者接受去甲肾上腺素和白蛋白输注治疗,反应良好。肺水肿在第3天消退,但持续存在气胸漏气,因此患者需要手术切除右肺尖部肺大疱。随后几天他病情好转出院。