Indian Journal of Anaesthesia  
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CASE REPORT
Year : 2014  |  Volume : 58  |  Issue : 3  |  Page : 330-333

Re-expansion pulmonary oedema - differential lung ventilation comes to the rescue


Department of Anaesthesia, Kasturba Medical College, Manipal University, Manipal, Karnataka, India

Correspondence Address:
Dr. H M Krishna
Department of Anaesthesia, Kasturba Medical College, Manipal University, Manipal - 576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.135051

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Re-expansion pulmonary oedema (REPE) is a rare complication following re-inflation of a chronically collapsed lung, which is often fatal. We present a case of a 22-year-old male who presented to the hospital with severe respiratory distress and a history of blunt abdominal trauma 3 months back. He was diagnosed to have left sided diaphragmatic hernia with a mediastinal shift to the right, and was posted for emergency repair of the same. After surgical decompression of the left hemi-thorax and reduction of the abdominal contents, re-expansion of the left lung was achieved, following which patient developed REPE. A left sided double lumen tube was then inserted to prevent flooding and cross contamination of the right lung and ventilation of both lungs was maintained intraoperatively. Post-operatively, REPE was successfully managed by differential lung ventilation with a lung salvage strategy to the left lung and a lung protective strategy to the right lung.


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