Acute respiratory distress syndrome of the contralateral lung after reexpansion pulmonary edema of a collapsed lung.
OBJECTIVE
To report that leukocyte-mediated acute injury may develop in a nonhypoxic lung after hypoxia-reoxygenation injury of the hypoxic lung and in other systemic organs in patients with reexpansion pulmonary edema.


METHODS
Case report analysis with examination of the literature.


METHODS
Intensive care unit of a university hospital.


METHODS
Three patients who developed leukocyte-mediated acute lung injury in the contralateral lung and systemic organ injury after ipsilateral reexpansion pulmonary edema of a collapsed lung.


METHODS
To rule out the possibility that the acute lung injury in the contralateral lung was an extension of the hypoxia-reoxygenation injury, we analyzed changes in leukocyte and platelet count in the peripheral blood in relation to the development of pulmonary edema in each lung. Changes in liver enzymes were also analyzed to detect hepatic dysfunction as evidence of systemic organ injury.


RESULTS
Both leukocyte and platelet counts decreased when reexpansion pulmonary edema developed, and decreased further when acute lung injury developed in the contralateral lung (F = 8.42, p = 0.037 for leukocytes, and F = 17.66, p = 0.01 for platelets). Significant hepatic dysfunction developed, as evidenced by increases in both serum bilirubin (p = 0.001) and lactic dehydrogenase, indicating the presence of systemic organ injury.


CONCLUSIONS
The hypoxia-reoxygenation injury of one lung can induce acute lung injury in the other lung and systemic organ injury.
Her
Charles
C
Department of Anesthesiology, New York Medical College, Valhalla, NY, USA. charles6133@msn.com
Mandy
Szabolcs
S
D000328:Adult; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008168:Lung / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010976:Platelet Count; D011654:Pulmonary Edema / Q000150:complications*; D015427:Reperfusion Injury / Q000150:complications* / Q000628:therapy; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000473:pathology; D013514:Surgical Procedures, Operative / Q000009:adverse effects
D010100:Oxygen