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Re-expansion Pulmonary Edema After Chest Tube Placement
- Tube thoracostomy is a common procedure in the emergency department.
- For patients who develop respiratory distress after chest tube placement, think about re-expansion pulmonary edema.
- While a rare occurrence, re-expansion pulmonary edema is reported to have a mortality rate of up to 20%.
- The mechanism by which edema forms remains controversial, but is thought to be due to increased alveolar-capillary membrane permeability in the expanding lung.
- Treatment is supportive with supplemental oxygen and diuretics. Some patients may require mechanical ventilation depending on the degree of distress and hypoxia.
References
Hsu KF, et al. Re-expansion pulmonary edema after insertion of chest tube for pneumothorax. J Trauma 2011;70(3):761.