Ipsilateral Reexpansion Pulmonary Edema Developed Following Decortication / 대한마취과학회지

ABSTRACT

Surgery and anesthesia-related ipsilateral reexpansion pulmonary edema has been seldom reported. The pathogenic mechanism of this rare complication is not clearly understood. A 23 year-old male had a decortication for left lung empyema under one-lung anesthesia. It took 6 hours to finish the scheduled operation. The patient came back to surgery again because of postoperative bleeding and he developed an ipsilateral pulmonary edema during the reexpansion of the collapsed lung. Fortunately, he was well tolerated with the developed edema which was resolved gradually without any specific management. The most likely mechanism is the increased pulmonary capillary permeability due to capillary injury resulting from hypoxia, oxygen free radicals, stretching, or surgieal manipulation. Secondly, the rise of the pulmonary capillary transmural pressure gradient and decreased lymphatic pump activity might also be involved as well.