2007 Volume 14 Issue 1 Pages 61-64
We successfully managed a case of serious hypovolemic shock with reexpansion pulmonary edema (RPE). A 47-year-old man developed pneumothorax 11 days after a previous injury. A thoracic cavity drain was inserted, but the patient's respiration and circulation became unstable and he experienced intense coughing. Systolic blood pressure dropped from 120 mmHg to 60 mmHg, and pulse rate increased from 80 min-1 to 120∼140 min-1. Central venous pressure became 0 mmHg and hematocrit increased from 32% to 45%, strongly suggesting hypovolemic shock. We were able to save him by loading a large quantity of infusion. Respiratory failure with RPE is common, but its association with serious hypovolemic shock has not been previously mentioned. When inserting a thoracic cavity drain, care must be taken to prevent respiratory and circulatory failure.
