Catastrophic circulatory collapse following re-expansion pulmonary oedema.
Re-expansion pulmonary oedema is a recognised but rare complication following the rapid drainage of a large pleural effusion or pneumothorax [1,2], usually occurring on the side of re-inflation. The pathogenesis of the pulmonary oedema is poorly understood but is thought to be due to micro-vascular shearing resulting in neutrophil activation and adhesion to the vascular endothelium resulting in increased micro-vascular permeability [3-7]. Few reports appear in the literature of invasive haemodynamic monitoring following this catastrophe. We describe a patient who sustained fatal pulmonary oedema arising in the contralateral lung, with pulmonary flow catheter data documenting the initial circulatory collapse following the aspiration of a massive pulmonary effusion.
Gascoigne
A
A
Intensive Therapy Unit, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
Appleton
A
A
Taylor
R
R
Batchelor
A
A
Cook
S
S
D000328:Adult; D002199:Capillary Permeability; D002448:Cell Adhesion; D004322:Drainage; D004730:Endothelium, Vascular / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D018056:Hemorheology; D006801:Humans; D018375:Neutrophil Activation; D010996:Pleural Effusion / Q000150:complications / Q000628:therapy; D001261:Pulmonary Atelectasis / Q000209:etiology / Q000628:therapy*; D011654:Pulmonary Edema / Q000209:etiology*; D012769:Shock / Q000209:etiology*