Turnage W S, Lunn J J
Department of Anesthesiology, University of South Florida College of Medicine, Tampa.
Chest. 1993 Jun;103(6):1646-50. doi: 10.1378/chest.103.6.1646.
Evaluate the correlation between intravenous fluid administration and postpneumonectomy pulmonary edema.
Retrospective chart review.
Large multispecialty group practice hospital.
Adults who had a pneumonectomy performed between 1977 and 1988.
Patients were identified who had postpneumonectomy pulmonary edema (PPE). Fluid administration and fluid balance information was found in records and compared with age- and sex-matched control patients who did not develop PPE. The side of pneumonectomy was noted for patients in each group. Autopsy findings were recorded for patients who died. Twenty-one patients met PPE criteria. No significant difference was found between groups for fluid administration or fluid balance. Patients who had right pneumonectomy had a significantly higher incidence of PPE. Patients with PPE had a 100 percent mortality rate and histologic evidence of the adult respiratory distress syndrome (ARDS) at autopsy.
PPE is caused by noncardiogenic pulmonary edema rather than excess intravenous fluid administration. There is a greater incidence of the syndrome with right pneumonectomy for unknown reasons. The mortality rate is high despite interventions for ARDS.
