Risk factors for the development of reexpansion pulmonary edema in patients with spontaneous pneumothorax

Abstract

BackgroundReexpansion pulmonary edema (REPE) is known as a rare and fatal complication after tube thoracostomy.ObjectivesWe investigated the risk factors for the development of REPE in patients with spontaneous pneumothorax.MethodsWe selected patients who were diagnosed with spontaneous pneumothorax and were initially treated with tube thoracostomy between August 1, 2003 and December 31, 2011. The patients’ electronic medical records, including operative notes and chest x-ray and computed tomography scans, were reviewed.ResultsREPE developed in 49 of the 306 patients (16.0%). REPE was more common in patients with diabetes (14.3% vs 3.9%, P = 0.004) or tension pneumothorax (46.8% vs 16.2%, P = 0.000). The pneumothorax was larger in patients with REPE than without REPE (57.0 ± 16.0% vs 34.2 ± 17.6%, P = 0.000), and the incidence of REPE increased with the size of pneumothorax. On multivariate analysis, diabetes mellitus [(odds ratio (OR) = 9.93, P = 0.003), and the size of pneumothorax (OR = 1.07, P = 0.000) were independent risk factors of REPE.ConclusionsThe presence of diabetes increases the risk of REPE development in patients with spontaneous pneumothorax. The risk of REPE also increases significantly with the size of pneumothorax.

Contralateral reexpansion pulmonary edema with ipsilateral collapsed lung after pleural effusion drainage: a case report

“…Because most cases are detected incidentally on radiography, the true incidence is still unclear (0.9 -20 %) [ 2 ]. The chest CT findings of reexpansion pulmonary edema are peripheral patchy lesions of ground glass opacity with a vascular distribution, which were usually associated with consolidation as well as interstitial thickening [ 2 – 4 ].…”

Severe Re-expansion Pulmonary Edema Induced by One-Lung Ventilation

“…In addition, Ͼ 30% of a collapsed lung field is another risk factor for RPE in patients with spontaneous pneumothorax, 3 and the incidence of RPE is higher when the collapsed lung is larger. 28 Because OLV was carried out in our 2 patients, almost 50% of the lung was collapsed. Thus, OLV itself may be a risk factor for RPE in patients who have preoperative lung injury and complications.…”

Severe re‐expansion pulmonary edema after conventional cardiac surgery: Identification and management

“…REPE was first reported in the mid‐1800s and is most commonly seen following large volume thoracentesis . Suggested risk factors for the development of REPE include; age between 20 and 40 years old, diabetes, duration of lung collapse, high negative pressures following drainage (more negative than ‐ 20 cmH2O), and draining greater than 1.5 L of fluid . Feller‐Kopman et al found in their retrospective review of 185 patients that REPE did not correlate with the amount of fluid withdrawn from the chest.…”