Two cases of spontaneous pneumothorax in which re-expansion pulmonary edema could not be prevented and tracheal intubation had to be performed

Abstract

Re-expansion pulmonary edema (RPE), caused by spontaneous pneumothorax, is a complication that can lead to death in severe cases, and rapid lung re-expansion has been reported as a risk factor for developing this complication. We experienced a case of RPE due to uncontrolled subcutaneous emphysema, which occurred after clamping a large-diameter drain despite attempts to slowly inflate the lung. On the other hand, a different patient with a small-diameter drain developed RPE after surgery because the lung did not expand sufficiently. Since it is often difficult to obtain appropriate lung re-expansion at the intended rate, it is important to always be prepared for the occurrence of severe RPE when treating patients with spontaneous pneumothorax, and to avoid missing the opportunity to perform tracheal intubation when treating cases who demonstrate RPE.