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复张性肺水肿:自发性气胸胸腔引流置入后罕见的并发症。

Re-expansion Pulmonary Edema: A Rare Complication of Chest Drain Insertion in Spontaneous Pneumothorax.

机构信息

Emergency Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu Sabah, Malaysia (Dr Firdaus Bolong); Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu Sabah, Malaysia (Dr Pang Tze Ping); and Emergency Department (Dr Shanmuga Ratnam) and Cardiothoracic Department (Dr Raja Badrol Hisham), Hospital Queen Elizabeth II, Kota Kinabalu, Sabah, Malaysia.

出版信息

Adv Emerg Nurs J. 2023;45(4):270-274. doi: 10.1097/TME.0000000000000481.

Abstract

Re-expansion pulmonary edema (RPE) after chest drain insertion is rare. The objective of this clinical case report is to highlight the importance of this chest drain insertion complication. A 35-year-old man presented to the emergency department with a chief complaint of shortness of breath and pleuritic chest pain. Further physical examination and radiographic investigations showed a left-sided hemipneumothorax. A chest drain was inserted, but subsequently the patient developed worsening shortness of breath, desaturation, and coughed out pink frothy sputum. Repeated chest radiographic and computed tomographic thorax findings suggested RPE. A nonrebreathable mask with high-flow oxygen was given to the patient to maintain his oxygen saturation. The patient was referred to the cardiothoracic team and was admitted to the hospital. Despite conservative management in the ward, the patient underwent lung decortication. Postdecortication, the left-sided lung re-expanded well, and the patient was discharged home. This case highlighted this rare, potentially fatal complication of chest drain insertion for spontaneous pneumothorax.

摘要

复张性肺水肿(RPE)在胸腔引流管插入后很少见。本临床病例报告的目的是强调这种胸腔引流管插入并发症的重要性。一名 35 岁男性因呼吸急促和胸痛就诊于急诊科。进一步的体格检查和影像学检查显示左侧血气胸。插入了胸腔引流管,但随后患者出现呼吸急促恶化、血氧饱和度下降和咳出粉红色泡沫痰。反复的胸部 X 线和胸部 CT 结果提示复张性肺水肿。给患者使用了带有高流量氧气的不可重复呼吸面罩以维持其血氧饱和度。患者被转介到心胸外科团队,并住院治疗。尽管在病房进行了保守治疗,但患者仍进行了肺剥脱术。肺剥脱术后,左侧肺部重新充分膨胀,患者出院回家。本病例强调了自发性气胸胸腔引流管插入后这种罕见但可能致命的并发症。

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