Lee Sang Kwon, Son Bong Soo, Son Joohyung, Lee Seung Eun, Yeo Hye Ju, Kim Do Hyung
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Medical Research Institute of Pusan National University, Yangsan, South Korea.
Department of Pulmonary and Critical care medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Ann Transl Med. 2019 Jun;7(12):272. doi: 10.21037/atm.2019.05.08.
Re-expansion pulmonary edema (REPE) is a lethal complication, which usually occurs after rapid re-expansion of a collapsed lung following chest tube insertion. As REPE can induce respiratory failure, mechanical ventilation is necessary in some cases. However, ventilator therapy can worsen ventilation perfusion mismatch at the initial stage of the treatment procedure, and increases the risk of fatality. To resolve this problem, it is advisable to maintain spontaneous breathing without using a mechanical ventilator. A high-flow nasal cannula can supply a high concentration of oxygen while maintaining spontaneous breathing in patients with dyspnea, which has recently emerged as an alternative to ventilators. We introduced a high-flow nasal cannula to treat REPE instead of a mechanical ventilator and successfully treated a patient with severe REPE.
复张性肺水肿（REPE）是一种致命的并发症，通常发生在胸腔插管后萎陷肺快速复张之后。由于REPE可诱发呼吸衰竭，某些情况下需要机械通气。然而，在治疗过程的初始阶段，机械通气治疗会加重通气灌注不匹配，并增加死亡风险。为解决这一问题，建议在不使用机械通气的情况下维持自主呼吸。高流量鼻导管可为呼吸困难患者提供高浓度氧气，同时维持自主呼吸，最近已成为机械通气的一种替代方法。我们引入高流量鼻导管而非机械通气来治疗REPE，并成功治疗了一名严重REPE患者。
