Cardiac output increases prior to development of pulmonary edema after re-expansion of spontaneous pneumothorax.
Pulmonary edema following reexpansion of spontaneous pneumothorax is an uncommon complication. The underlying mechanism of this condition is unclear. We report the hemodynamic characteristics in a series of 7 male patients with spontaneous large (>50%) pneumothoraces of > or = 24 h and correlate the changes with reexpansion pulmonary edema (REPE). A pulmonary artery floatation catheter was inserted and hemodynamic data were obtained before therapeutic chest tube insertion, 1 h after chest tube insertion and the following day. Four (57%) patients developed REPE. There was a tendency for larger pneumothorax to develop REPE. Capillary wedge pressure did not change significantly 1 h after the insertion of chest tube in all our patients. Cardiac output increased significantly in patients who developed REPE compared to those who did not (+ 1.06 l/min vs -0.27 l/min; P = 0.03) 1 h after insertion of chest tube. One patient did not develop pulmonary edema despite having a large (> 80%) pneumothorax. His cardiac output did not rise 1 h after chest tube insertion. REPE is not an uncommon complication following chest tube drainage in patients with large and long-standing pneumothorax. The increase in cardiac output after chest tube insertion may be associated with subsequent development of REPE.
Tan
H C
HC
Division of Cardiology, Changi General Hospital, Singapore.
Mak
K H
KH
Johan
A
A
Wang
Y T
YT
Poh
S C
SC
D000328:Adult; D000368:Aged; D002302:Cardiac Output / Q000502:physiology*; D015505:Chest Tubes / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D011654:Pulmonary Edema / Q000209:etiology* / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure / Q000502:physiology