이차성 자연기흉 환자에게 폐쇄식 흉관삽입술로 인한 재팽창성 폐부종에 관한 증례보고

• Published in: Journal of medicine and life science 2021-12, Vol.18 (3), p.61-65
• Main Authors: 오선우, 김수완, Seon Woo Oh, Su Wan Kim
• Format: Article
• Language: Korean
• ISSN: 1738-1010; 2671-4922
• DOI: 10.22730/jmls.2021.18.3.61

Although re-expansion pulmonary edema (RPE) is rare (incidence rate 20%; therefore, early diagnosis and treatment are important. We report a case of RPE following chest tube insertion in a patient with spontaneous pneumothorax. We have specifically focused on the mechanism underlying RPE and the possible etiology. An 82-year-old man with a history of chronic anemia, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension was referred to the emergency department for management of recurrent right-sided pneumothorax. We performed emergency closed thoracostomy for suspected tension pneumothorax, which led to stabilization of the patient's vital signs; however, he coughed up frothy pink sputum accompanied by severe right-sided chest pain 30 min postoperatively. The patient showed new-onset right pulmonary consolidation on chest radiography, as well as desaturation, tachycardia, and tachypnea and was diagnosed with RPE. He was transferred to the intensive care unit for mechanical ventilation and supportive treatment using diuretics, ionotropic agents, and prophylactic antibiotics. RPE gradually resolved, and the patient was extubated 3 days after admission. He has not experienced recurrent pneumothorax or pulmonary disease for 4 months. We emphasize the importance of RPE prevention and that aggressive ventilator care and supportive treatment can effectively treat RPE following an accurate understanding of the underlying pathogenetic mechanisms and risk factors.