title: Severe Re-expansion Pulmonary Edema Induced by One-Lung Ventilation.
abstract: We present 2 cases of severe re-expansion pulmonary edema (RPE) after one-lung ventilation (OLV) for thoracic surgery. A 32-y-old woman with multiple lung metastases developed severe RPE after OLV during lung resection surgery. A 37-y-old man with infective endocarditis also developed severe RPE after OLV for mitral valve plasty with minimally invasive cardiac surgery. In both cases, results of a preoperative pulmonary function test and oxygenation were almost normal, and pleural effusion or pulmonary congestion was not detected in preoperative computed tomography; however, there was a possibility that subclinical lung injury existed before surgery. The levels of interleukin-8 and monocyte chemotactic protein-1, which are thought to play important roles in the development of lung injury, in bronchial secretions were extremely high after the onset of RPE. These results suggest that the pathogenesis of RPE shares, at least in part, a common pathophysiology of acute lung injury.
authors.affiliation: Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan. ysugiyama@shinshu-u.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sugiyama
authors.affiliation: Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Shimizu
authors.affiliation: Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
authors.forename: Sari
authors.initials: S
authors.lastname: Shimizu
authors.affiliation: Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Urasawa
authors.affiliation: Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
authors.forename: Mikito
authors.initials: M
authors.lastname: Kawamata
mesh_terms: D000328:Adult; D018932:Chemokine CCL2 / Q000032:analysis; D004696:Endocarditis / Q000601:surgery; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000032:analysis; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects*; D009093:Mucus / Q000737:chemistry / Q000378:metabolism; D061810:One-Lung Ventilation / Q000009:adverse effects*; D011654:Pulmonary Edema / Q000209:etiology*; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*
chemical_list: D018932:Chemokine CCL2; D016209:Interleukin-8
keywords: interleukin-8; monocyte chemotactic protein-1; one-lung ventilation; pulmonary edema