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自发性气胸楔形切除术后意外发生肺水肿和心脏骤停——一例报告

Unexpected pulmonary edema and cardiac arrest following wedge resection of spontaneous pneumothorax -A case report.

作者信息

Han Woong, Kim Gyu Seong, Lee Jong Min, Lim Chang Mook, Yang Hong Seuk, Jeong Chang Yeong, Park Dong Ho

机构信息

Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea.

出版信息

Anesth Pain Med (Seoul). 2022 Jul;17(3):298-303. doi: 10.17085/apm.21116. Epub 2022 Jun 17.

DOI:10.17085/apm.21116
PMID:35918863
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9346198/
Abstract

BACKGROUND

Reexpansion pulmonary edema is a rare but potentially lethal complication. We report a case of suspected reexpansion pulmonary edema that led to cardiac arrest.

CASE

A 16-year-old male patient underwent wedge resection due to right pneumothorax. The patient showed pink frothy sputum three hours following surgery, and a chest x-ray showed right unilateral pulmonary edema. Thirteen hours following surgery, the patient continuously showed pink frothy sputum and presented with severe hypoxemia, tachypnea, and tachycardia. After transferring to the intensive care unit (ICU), he developed ventricular tachycardia. Cardiopulmonary resuscitation was performed for 32 min. Chest X-ray showed diffuse bilateral pulmonary edema. Extracorporeal membrane oxygenation was performed. During the 65 days of ICU care, the patient became mentally alert. However, follow-up echocardiography revealed severe heart failure.

CONCLUSIONS

Rexpansion pulmonary edema can rapidly progress to diffuse bilateral pulmonary edema. Therefore, careful observation is required for the patients who show signs of pulmonary edema after reexpansion.

摘要

背景

复张性肺水肿是一种罕见但可能致命的并发症。我们报告一例疑似复张性肺水肿导致心脏骤停的病例。

病例

一名16岁男性患者因右侧气胸接受楔形切除术。术后三小时患者出现粉红色泡沫痰,胸部X光显示右侧单侧肺水肿。术后13小时,患者持续出现粉红色泡沫痰,并伴有严重低氧血症、呼吸急促和心动过速。转至重症监护病房(ICU)后,他出现室性心动过速。进行了32分钟的心肺复苏。胸部X光显示双侧弥漫性肺水肿。进行了体外膜肺氧合。在ICU护理的65天里,患者神志清醒。然而,随访超声心动图显示严重心力衰竭。

结论

复张性肺水肿可迅速发展为双侧弥漫性肺水肿。因此,对于复张后出现肺水肿迹象的患者需要仔细观察。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/10034c40825c/apm-21116f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/f7016f5d8807/apm-21116f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/734e3132890e/apm-21116f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/e55daaede40a/apm-21116f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/10034c40825c/apm-21116f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/f7016f5d8807/apm-21116f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/734e3132890e/apm-21116f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/e55daaede40a/apm-21116f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f1/9346198/10034c40825c/apm-21116f4.jpg

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