Mayeur Nicolas, Groyer Samuel, Vimeux Sylvie, Roustan Jérôme
Cardiac and Thoracic Surgery, Clinique Pasteur, Toulouse, France.
Polyvalent Intensive Care Unit, CH Montauban, Montauban, France.
Case Rep Emerg Med. 2021 May 11;2021:6677656. doi: 10.1155/2021/6677656. eCollection 2021.
Spontaneous pneumothorax is a frequent situation in respiratory medicine, and its treatment is based on conservative treatment or pleural drainage. Reexpansion pulmonary edema (REPE) is often a mild complication following pneumothorax drainage. We report here a severe case of unilateral REPE following spontaneous pneumothorax drainage associated with major pulmonary plasmatic leakage. The clinical presentation was severe and sudden with respiratory and circulatory failures. Initial resuscitation was mostly based on prone and head-down positioning in association to fluid expansion and mechanical ventilation. On the basis of this clinical case report, we strongly suggest to think about severe pulmonary reexpansion edema when respiratory and hemodynamic failures occur few hours after pneumothorax-related efficient pleural tube drainage.
自发性气胸是呼吸医学中的常见病症，其治疗基于保守治疗或胸腔引流。复张性肺水肿（REPE）通常是气胸引流后的一种轻度并发症。我们在此报告一例自发性气胸引流后发生的严重单侧REPE病例，伴有大量肺血浆渗漏。临床表现严重且突发，伴有呼吸和循环衰竭。初始复苏主要基于俯卧位和头低位，并结合液体扩容和机械通气。基于本临床病例报告，我们强烈建议，当气胸相关有效胸腔引流数小时后出现呼吸和血流动力学衰竭时，应考虑严重的肺复张性肺水肿。
