• Journal of Chest Surgery
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• v.24 no.8
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• pp.797-801
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• 1991

Reexpansion pulmonary edema following pneumothorax, atelectasis, massive pleural effusion are clinically uncommon, but sometimes life threatening progression. Reexpansion pulmonary edema is usually ipsilateral but rarely contralateral or both. Reexpansion pulmonary edema was occurred when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. The pathogenesis of the reexpansion pulmonary edema is unknown but is probably mutifactorial. The etiological factors of the reexpansion pulmonary edema are chronicity of the lung collapse, technique of the reexpansion, airway obstruction, loss of the surfactant, and pulmonary artery pressure changes. In the treatment of the chronically collapsed lung, physician must be remembered the possible events, and to prevent of the complication.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.510-512
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• 1995

Reexpansion pulmonary edema following treatment of pneumothorax and pleural effusion is a rare complication. However, because of possibility of its fatal outcome, physicians must be aware of this complication and every effort must be made to prevent its occurrence. We experienced 5 cases of reexpansion of pulmonary edema. One was complete tension pneumothorax and became death despite of intensive management. Remained four were 3 pneumothoraces and 1 pleural effusion and discharged without event, fortunately.

• Tuberculosis and Respiratory Diseases
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• v.51 no.2
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• pp.161-165
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• 2001

Acute bilateral reexpansion pulmonary edema after pleurocentesis is a rare complication. In one case, bilateral reexpansion pulmonary edema after unilateral pleurocentensis in sarcoma was reported. Various hypotheses regarding the mechanism of reexpansion pulmonary edema include increased capillary permeability due to hypoxic injury, decreased surfactant production, altered pulmonary perfusion and mechanical stretching of the membranes. Ragozzino et al suggested that the mechanism leading to unilateral reexpansion pulmonary edema involves the opposite lung when there is significant contralateral lung compression. Here we report a case of bilateral reexpansion pulmonary edema and acute respiratory distress syndrome after a unilateral pleurocentesis of a large pleural effusion with contralateral lung compression and increased interstitial lung marking underlying chronic liver disease.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.581-584
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• 1996

Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothordx, pleural effusion, or atelectasis but occasionally life threatening. Generally, reexpansion pulmonary edema is believed to o cur only when a chronically collapsed lung is rapidly reexpanded by evacuation or large amounts of air or fluid. This complication is heralded by tachypnea, unilateral rales, and profuse expectoration of frothy secretion within several hours of reexpansion. Increased dur- ation of pneumothorax and the use o( suction are important factors in the generation of reexpansion pulmonary edema. We had experienced 3 cases of reexpansion pulmonary edema. In the two cases the pneumothorax had been present for several days, and, after insertion of a chest tube, pulmonary edema developed unilaterally but improved with supplemental oxygen. In the third case, massive pleural effusion was present. and, after insertion of a chest tube, pulmonary edema developed unilaterally, followed by cardiac arrest. He died of pulmonary edema inspire of resuscitation.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.527-530
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• 2003

Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. But occasionally, severe morbidity and death may result. Reexpansion pulmonary edema occurs when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. In the treatment of the chronically collapsed lung, physicians must remember the possible events and prevent the complications. When the difference in airway resistance or lung compliance between the two lungs is exaggerated, conventional mechanical ventilation might lead to preferential ventilation with hyperexpansion of one lung and gradual collapse of the other. Differential ventilation has been advocated to avert this problem. By differential lung ventilation, we successfully treated a severe reexpansion pulmonary edema in two patients. Therefore we suggest that differential lung ventilation is the treatment of choice for severe reexpansion pulmonary edema.

• Journal of Chest Surgery
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• v.26 no.9
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• pp.718-721
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• 1993

Reexpansion pulmonary edema[ RPE ] with hypoxemia and hypotension is a very rare complication of the treatment of lung collapse secondary to pneumothorax and pleural effusion. We experienced two cases of RPE. One is a 29 year old male with complete right pneumothorax and the other is a 20 year old female with massive right pleural effusion. Life threatening pulmonary edema was developed soon after insertion of chest tube in both. Fortunately, RPE was detected early and intensive treatment was performed. They were discharged without complication. Although RPE with hypoxemia and hypotension is rare , it is very serious and occasionally life-threatening. So, chest surgeon treating lung collapse must be aware of the possibility of RPE and make an effort to prevent the occurence of this condition.

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.59-62
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• 2009

Reexpansion pulmonary edema is not a common phenomenon after chest tube insertion but some reports from 0% to 14%. There are various resulting complications, including acute respiratory distress syndrome. We report a case of focal reexpansion pulmonary edema after chest tube insertion. A 49-year-old male came to the hospital due to ongoing dyspnea and left chest pain for 3 days. On chest X-ray, the patient had a left pneumothrax. We planned to insert a chest tube for symptom relief. To determine whether or not the chest had expanded as a result of the chest tube insertion, the patient underwent repeated chest X-rays the following day. The patient experienced brief respiratory symptoms upon initial suction; a chest PA showed patchy consolidated infiltration at the inserted site. After 5 days of conservative management, the recovered completely.

• Tuberculosis and Respiratory Diseases
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• v.56 no.3
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• pp.297-301
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• 2004

A 60-year old male patient admitted with complaints of dyspnea and pleuritic chest pain. The chest X-ray demonstrated right pleural effusion. We planed to do the conventional thoracentesis to evaluate the characteristics of pleural effusion and to relieve the symptom of the patient. Focal reexpansion pulmonary edema was seen on the follow-up chest X-ray. After the 5-day conservative management, the patient recovered without any complications.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1149-1153
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• 1997

Unilateral reexpansion pulmonary edema(RPE) is generally considered a rare complication occurring when a chronically atelectatic lung is rapidly reexpanded by tube thoracostomy or thoracentesis. It can also take place when the lung collapse is of short duration or when the lung is reexpanded without intrapleural sucti n. We experienced a case of RPE following surgical resection in mediastinal thymic cyst A 26 year old female patient suffered from long-standing atelectasis of the right lung due to a huge mediastinal cyst that was misrecognized as tuberculous pleural effusion. Empyema developed after iatrogenic rupture of mediastinal cyst by pig-tailed tube thoracostomy. We successfally managed the ruptured mediastinal thymic cyst, empyema and postoperatively developed RPE following reexpansion of the collapsed lung. The patient was treated with drugs and mechanical ventilation with positive end-expiratory pressure for RPE. The remainder of her hospital course was uneventful.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.81-84
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• 1995

Re-expansion pulmonary edema following pneumothorax or hemothorax is clinically uncommon but occasionally life threatening. Clinical details are given of two patients.Ipsilateral pulmonary edema were developed after chest tube insertion due to spontaneous pneumothorax in case I and after evacuation of postoperative hemothorax in case II. The patients were treated with frequent bronchial toilet.The administration of colloid solution and diuretics was effective. The possible mechanisms underlying the edema are discussed.Both increased time of collapse and suction tended to correlate with reexpansion edema.The present two cases provided evidence for longstanding lung collapse and immediate application of suction.