Angel G, Andreu J M, Aulagnier V, Diatta B, Seck M, Seignot P
Service de réanimation, hôpital principal de Dakar, Sénégal.
Ann Fr Anesth Reanim. 1997;16(4):370-3. doi: 10.1016/s0750-7658(97)81463-3.
We report an acute respiratory insufficiency following the removal of a large intrathoracic fibroma (3.1 kg) in a 6 year-old child, caused by a re-expansion pulmonary oedema (unilateral oedema occurring within one hour after expansion). This oedema improved rapidly and was followed by a well-tolerated pleural effusion. This complication is due to discrepancy between a small lung and a large thoracic cavity, due to the prolonged time course of the tumor growth. These oedemas are caused by rapid lung re-expansion, the volume of the removed tumor and the depth of postoperative pleural suction. The value of positive-end expiratory pressure is discussed.
我们报告了一名6岁儿童在切除一个巨大的胸内纤维瘤(3.1千克)后出现急性呼吸功能不全,这是由肺复张性肺水肿(扩张后一小时内出现的单侧水肿)引起的。这种水肿迅速改善,随后出现了耐受性良好的胸腔积液。这种并发症是由于肿瘤生长时间延长导致小肺与大胸腔之间的差异所致。这些水肿是由肺的快速复张、切除肿瘤的体积和术后胸腔抽吸的深度引起的。文中讨论了呼气末正压的价值。