title: Bilateral pulmonary edema after endoscopic sympathectomy in a patient with glucose-6-phosphate dehydrogenase deficiency.
abstract: Transaxillary endoscopic sympathectomy of thoracic ganglia (T2-T3) has recently gained wider acceptance as the treatment of choice for palmar hyperhidrosis. It requires one-lung ventilation to facilitate the surgery. One-lung ventilation, however, is not without complications, among which acute pulmonary edema has been reported. In this case report, we present a patient with palmar hyperhidrosis complicated by glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, who received bilateral endoscopic sympathectomy under alternate one-lung anesthesia, and developed acute pulmonary edema immediately after recruitment of the successive collapsed lung. The effects of hypoxemia, G-6-PD deficiency and sympathectomy might all add to the development of acute pulmonary edema secondary to reexpansion of each individual lung after alternate one-lung ventilation. The possibilities of the inferred causes are herein discussed.
authors.affiliation: Department of Anesthesiology, Veterans General Hospital-Taipei, School of Medicine, National Yang-Ming University, Taiwan, ROC. blues729@ms36.hinet.net
authors.forename: C J
authors.initials: CJ
authors.lastname: Lan
authors.forename: H N
authors.initials: HN
authors.lastname: Luk
authors.forename: C T
authors.initials: CT
authors.lastname: Wu
authors.forename: W K
authors.initials: WK
authors.lastname: Chang
authors.forename: M Y
authors.initials: MY
authors.lastname: Tsou
authors.forename: P W
authors.initials: PW
authors.lastname: Lui
authors.forename: T Y
authors.initials: TY
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D000328:Adult; D004724:Endoscopy; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications*; D006801:Humans; D006945:Hyperhidrosis / Q000209:etiology / Q000601:surgery; D008297:Male; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology*; D013902:Radiography, Thoracic; D012121:Respiration, Artificial; D013562:Sympathectomy / Q000009:adverse effects*