title: Re-expansion pulmonary oedema - differential lung ventilation comes to the rescue.
abstract: Re-expansion pulmonary oedema (REPE) is a rare complication following re-inflation of a chronically collapsed lung, which is often fatal. We present a case of a 22-year-old male who presented to the hospital with severe respiratory distress and a history of blunt abdominal trauma 3 months back. He was diagnosed to have left sided diaphragmatic hernia with a mediastinal shift to the right, and was posted for emergency repair of the same. After surgical decompression of the left hemi-thorax and reduction of the abdominal contents, re-expansion of the left lung was achieved, following which patient developed REPE. A left sided double lumen tube was then inserted to prevent flooding and cross contamination of the right lung and ventilation of both lungs was maintained intraoperatively. Post-operatively, REPE was successfully managed by differential lung ventilation with a lung salvage strategy to the left lung and a lung protective strategy to the right lung.
authors.affiliation: Department of Anaesthesia, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Shreepathi K
authors.initials: SK
authors.lastname: Achar
authors.affiliation: Department of Anaesthesia, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Souvik
authors.initials: S
authors.lastname: Chaudhuri
authors.affiliation: Department of Anaesthesia, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Hm
authors.initials: H
authors.lastname: Krishna
authors.affiliation: Department of Anaesthesia, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Ms
authors.initials: M
authors.lastname: Sagar
keywords: Differential lung ventilation; double lumen tube; re-expansion pulmonary oedema