Abstract
We report a case of spontaneous pneumothorax developed re-expansion pulmonary edema (RPE) associated with hypovolemic shock after chest drainage. The patient was a 43-year-old man suffering from right spontaneous pneumothorax. Chest drainage was conducted on the 10th day after the onset of the symptoms. Thereafter the patient produced a large amount of frothy sputum and his cardiopulmorary dynamics became unstable. He was diagnosed with RPE and respiratory management using mechanical ventilation with PEEP was started. The systolic blood pressure was 60 mmHg, the heart rate was 120 times per minute, and the patient went into shock. Cardiovascular management was done by transfusion loading and administration of a vasopressor. Eventually his life could be saved by administration of sivelestat sodium hydrate and steroids.
RPE that occurs after chest drainage or thoracentesis for pneumothorax is a serious complication. RPE can be associated with hypovolemic shock as well as respiratory failure, so that careful cardiopulmonary management would be mandatory for the treatment.
