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
HsuKF, et al. Re-expansion pulmonary edema after insertion of chest tube for pneumothorax. J Trauma 2011;70(3):761.
