Reexpansion Pulmonary Edema Occurred after Evacuating the Hepatic Hydrothorax in a Liver Transplant Patient: A case report.
10.4097/kjae.2006.50.1.103
- Author:
Mikyung YANG
1
;
Hak Jin KIM
;
Jin San HEO
;
Gaab Soo KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. gskim@smc.samsung.co.kr
- Publication Type:Case Report
- Keywords:
double lumen endotracheal tube;
hepatic hydrothorax;
liver transplantation;
reexpansion pulmonary edema
- MeSH:
Ascites;
Fibrosis;
Humans;
Hydrothorax*;
Hypertension, Portal;
Liver Diseases;
Liver Transplantation;
Liver*;
Lung;
Male;
Middle Aged;
Oxygen;
Pleural Effusion;
Pulmonary Edema*
- From:Korean Journal of Anesthesiology
2006;50(1):103-107
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A hepatic hydrothorax is a pleural effusion that develops in patients with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. It is a complication of end-stage liver disease, and a liver transplant is the treatment of choice. In our case, a reexpansion pulmonary edema occurred after evacuating 4,250 ml of ascites and aspirating 3,600 ml of the pleural effusion within 15 minutes aimed at visually improving the surgical field in a 46-year-old male patient receiving a liver transplant. 1 hour 30 minutes after aspirating the pleural effusion, the level of oxygen saturation decreased from 100% to 95%, and serosanguinous fluid spilled over from the endotracheal tube. We inserted a double lumen endotracheal tube to both separate and protect the unaffected left lung, and applied CPAP 10 cmH2O at the affected right lung. The reexpansion pulmonary edema was successfully treated using this supportive management.
