Re-Expansion Pulmonary Edema After Video-Assisted Thoracic Pleural Biopsy

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Medically Challenging Case Report Poster 


John Foote  
Mount Sinai Hospital


A 74 year old male with a history of recurrent right pleural effusions was admitted for dyspnea. CT of the chest confirmed right sided pleural effusion and plan was made for video-assisted thoracic surgery drainage and pleural biopsy. During one-lung ventilation, 4L of serosanguinous fluid was evacuated and chest tube was placed. Patient was extubated after exceeding extubation criteria. Patient became hypoxic, unresponsive, and hypotensive. CPR initiated and reintubated with ROSC achieved in 3 minutes. Frothy fluid poured from the endotracheal tube patient and was treated for re-expansion pulmonary edema. Chest x-ray showed unilateral opacification consistent with pulmonary edema. We discuss the differential and treatment for re-expansion pulmonary edema.

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Enter up to two references.

1. Barbetakis N, Samanidis G, Paliouras D, Tsilikas C. ARTICLE IN PRESS Case report-Thoracic general Re-expansion pulmonary edema following video-assisted thoracic surgery for recurrent malignant pleural effusion. Interact Cardiovasc Thorac Surg. 2008;7:532-534. doi:10.1510/icvts.2007.167312
2. Meira Dias O, Ribeiro Teixeira L, Vargas FS. Reexpansion pulmonary edema after therapeutic thoracentesis. Clinics. 2010;65(12):1387-1389. doi:10.1590/S1807-59322010001200026