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Wahyu Subekti
Department of Pulmonology and Respiratory Medicine Faculty of Medicine, Universitas Indonesia

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Re-expansion Pulmonary Edema Prasenohadi Prasenohadi; Wahyu Subekti
Respiratory Science Vol. 4 No. 1 (2023): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i1.130

Abstract

Re-expansion pulmonary edema (RPE) is a rare complication of pleural puncture (thoracentesis) and chest tube insertion. The incidence of RPE is low (1%), but mortality can be up to 20%. The main pathophysiological mechanism is pulmonary edema due to increased permeability and increased hydrostatic pressure in the pulmonary capillaries. Risk factors include duration of lung collapse (>3 to 7 days), size of pneumothorax (>30%), volume of aspirated air or fluid (>1.5 to 3 L), excessive negative intrapleural pressure, diabetes mellitus, and chronic hypoxemia. Prevention includes limiting the volume of aspirated air or fluid (<1.5 L), air or fluid evacuation in a controlled manner, and preventing excessive negative intrapleural pressure. Treatment is supportive care through cardiovascular and respiratory monitoring, oxygen and decubitus positioning.