NHÂN MỘT TRƯỜNG HỢP PHÙ PHỔI DO TÁI GIẢN NỞ PHỔI SAU DẪN LƯU KHÍ MÀNG PHỔI

Phát Hồ Ngọc; Anh Phạm Quách Tuấn; Xứng Nguyễn Văn

Keywords:

Pneumothorax, Pulmonary edema, Chest drainage, Reexpansion

Abstract

Reexpansion pulmonary edema (RPE) is a rare complication that may occur after treatment of lung collapse caused by pneumothorax, atelectasis or pleural effusion and can be fatal in 20% of cases. The pathogenesis of RPE is probably related to histological changes of the lung parenchyma and reperfusion-damage by free radicals leading to an increased vascular permeability. RPE is often self-limiting and treatment is supportive. A 29 year-old male patient was treated by intercostal drainage for a spontaneous pneumothorax. Shortly afterwards he developed reexpansion pulmonary edema and was transferred to the intensive care unit for invasive ventilatory support. Gradually, the edema diminished after the 5-day treatment and the patient could be discharged from intensive care unit in good clinical condition. RPE is characterized by rapidly progressive respiratory failure after intercostal chest drainage. Early recognition of signs and symptoms of RPE is important to initiate early management and allow for a favorable outcome.

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