Non-cardiogenic pulmonary oedema. A serious complication of transurethral prostatectomy. A case report.
A patient undergoing prostatectomy under epidural analgesia developed clinical signs of a severe TURP syndrome. During resuscitation, it was revealed that serum sodium was only moderately decreased. Plasma oncotic pressure was, however, markedly decreased and the pressure gradient between plasma oncotic pressure and pulmonary capillary wedge pressure (approximately hydrostatic pressure) was 1 mmHg (0.13 kPa) only, allowing almost free filtration of fluid through the pulmonary capillary wall, resulting in a non-cardiogenic pulmonary edema. The patient was successfully resuscitated with albumin and inotropic stimulation with prenalterol.
D000368:Aged; D002316:Cardiotonic Agents / Q000494:pharmacology; D003102:Colloids; D004562:Electrocardiography; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007552:Isotonic Solutions; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects; D011183:Postoperative Complications; D011217:Practolol / Q000031:analogs & derivatives / Q000494:pharmacology; D011294:Prenalterol; D011468:Prostatectomy; D011654:Pulmonary Edema / Q000209:etiology* / Q000503:physiopathology; D013268:Stimulation, Chemical; D007507:Therapeutic Irrigation / Q000009:adverse effects
D002316:Cardiotonic Agents; D003102:Colloids; D007552:Isotonic Solutions; D011294:Prenalterol; D011217:Practolol