Application of Pulse Contour Cardiac Output (PiCCO) system for adequate fluid management in a patient with severe reexpansion pulmonary edema.
We report a case of severe reexpansion pulmonary edema that occurred immediately after reinflation of a collapsed lung by rapid negative pressure drainage of prolonged malignant pleural effusion and pneumohemothorax. Although hemodynamic stability was difficult to maintain under aggressive treatment with inhalation of nitric oxide, inotropics and prostacyclin infusion, conventional pulmonary artery catheterization was not adequate for surveillance and adjustment of fluid therapy. For balancing the preload and the extent of pulmonary edema, pulse contour cardiac output monitoring using a single transpulmonary thermal dilution technique was applied to achieve optimal cardiac preload for organ perfusion and to prevent worsening of pulmonary edema from fluid overload.
Hung
Ming-Hui
MH
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
Chan
Kuang-Cheng
KC
Chang
Chia-Ying
CY
Jeng
Chuen-Shin
CS
Cheng
Ya-Jung
YJ
D000328:Adult; D002302:Cardiac Output; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D001261:Pulmonary Atelectasis / Q000150:complications*; D011654:Pulmonary Edema / Q000503:physiopathology / Q000628:therapy*