[A case of re-expansion pulmonary edema after one lung ventilation for the radical operation of lung cancer].
A 64-yr-old man was admitted to our hospital for the examination of the abnormal shadow in his left lung field, which was diagnosed later as lung cancer. Radical operation was scheduled under combined epidural/general anesthesia. One lung ventilation was performed to facilitate the operative procedure for two hours and fifteen minutes. About two hours after the re-expansion of his left lung, he complained of dyspnea. He was hypoxic and moist rale was audible in his left lung. Cloudy shadow emerged in the left field of his chest X-P. Under bronchofiberoptic observation, excessive serous secretions was seen, but no obstructive lesions were found in his bronchial tree. Re-expansion pulmonary edema was suspected for these findings. It was improved with mechanical ventilation with PEEP. Re-expansion pulmonary edema seldom occurs in one lung anesthesia. Although radical operation of esophageal cancer performed six years before might have induced the development of re-expansion pulmonary edema in our case, complete collapse with quick re-expansion of the lung is clearly a potential risk of re-expansion pulmonary edema. Careful management is necessary after one lung ventilation.
Asao
Yasuhiro
Y
Department of Anesthesia, Tottori Municipal Hospital, Tottori 680-8501.
Kobayashi
Motomu
M
Tsubaki
Noriko
N
Kobayashi
Osamu
O
Uehara
Kenji
K
D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications; D011654:Pulmonary Edema / Q000209:etiology* / Q000628:therapy; D012121:Respiration, Artificial / Q000379:methods*