A common gesture with a rare but potentially severe complication: Re-expansion pulmonary edema following chest tube drainage.
Journal
Respiratory medicine case reports
ISSN: 2213-0071
Titre abrégé: Respir Med Case Rep
Pays: England
ID NLM: 101604463
Informations de publication
Date de publication:
2019
2019
Historique:
received:
19
03
2019
revised:
03
04
2019
accepted:
05
04
2019
entrez:
25
4
2019
pubmed:
25
4
2019
medline:
25
4
2019
Statut:
epublish
Résumé
Primary Spontaneous Pneumothorax (PSP) is usually considered as a benign pathology occurring in young people. In about half of cases, observation only is purposed. In case of intervention, chest tube drainage remains the preponderant strategy even if no studies conclude about superiority of drainage or aspiration. Re-expansion pulmonary edema (REPE) is a rare but potentially severe complication of chest tube drainage. Risk factors are not well identified, but REPE is more frequent for patients with diabetes, younger than 40 years, with large pneumothorax, lung collapse more than one week and fast re-expansion. We report a case of a 19-year old male presenting to the Emergency Department with a first episode of PSP. He was treated by chest tube drainage with immediate suction. He developed a REPE 3 hours after chest tube drainage with suction. Conservative management and oxygen therapy led to withdrawing the chest tube 9 days later. For the initial management of PSP, prevention of this complication is essential. In case of risk factors, prevention consist of absence of immediate suction after chest tube drainage and suction should be reserved in case of failure of initial treatment after 24 hours. Even if chest tube drainage is a common gesture, clinical presentation of REPE must alert physicians taking care of these patients.
Sections du résumé
BACKGROUND
BACKGROUND
Primary Spontaneous Pneumothorax (PSP) is usually considered as a benign pathology occurring in young people. In about half of cases, observation only is purposed. In case of intervention, chest tube drainage remains the preponderant strategy even if no studies conclude about superiority of drainage or aspiration. Re-expansion pulmonary edema (REPE) is a rare but potentially severe complication of chest tube drainage. Risk factors are not well identified, but REPE is more frequent for patients with diabetes, younger than 40 years, with large pneumothorax, lung collapse more than one week and fast re-expansion.
CASE REPORT
METHODS
We report a case of a 19-year old male presenting to the Emergency Department with a first episode of PSP. He was treated by chest tube drainage with immediate suction. He developed a REPE 3 hours after chest tube drainage with suction. Conservative management and oxygen therapy led to withdrawing the chest tube 9 days later.
CONCLUSION
CONCLUSIONS
For the initial management of PSP, prevention of this complication is essential. In case of risk factors, prevention consist of absence of immediate suction after chest tube drainage and suction should be reserved in case of failure of initial treatment after 24 hours. Even if chest tube drainage is a common gesture, clinical presentation of REPE must alert physicians taking care of these patients.
Identifiants
pubmed: 31016133
doi: 10.1016/j.rmcr.2019.100838
pii: S2213-0071(19)30096-6
pii: 100838
pmc: PMC6475766
doi:
Types de publication
Case Reports
Langues
eng
Pagination
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