title: Acute respiratory distress syndrome of the contralateral lung after reexpansion pulmonary edema of a collapsed lung.
abstract: 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.
authors.affiliation: Department of Anesthesiology, New York Medical College, Valhalla, NY, USA. charles6133@msn.com
authors.forename: Charles
authors.initials: C
authors.lastname: Her
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Mandy
mesh_terms: 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
chemical_list: D010100:Oxygen