Case Report: Bilateral reexpansion pulmonary edema following treatment of a unilateral hemothorax. 2014

Steven P de Wolf, and Jaap Deunk, and Alexander D Cornet, and Paul Wg Elbers
Department of Intensive Care Medicine, VU University Medical Center, De Boelelaan 1117, 1081 HZ, Amsterdam, Netherlands ; Department of Anesthesiology, VU University Medical Center, De Boelelaan 1117, 1081 HZ, Amsterdam, Netherlands ; Institute for Cardiovascular Research VU (ICaR-VU), De Boelelaan 1117, 1081 HZ, Amsterdam, Netherlands ; Research VUmc Intensive Care (REVIVE), De Boelelaan 1117, 1081 HZ, Amsterdam, Netherlands.

Bilateral re-expansion pulmonary edema (RPE) is an extremely rare entity. We report the unique case of bilateral RPE following a traumatic, unilateral hemopneumothorax in a young healthy male. Bilateral RPE occurred only one hour after drainage of a unilateral hemopneumothorax. The patient was treated with diuretics and supplemental oxygen. Diagnosis was confirmed by excluding other causes, using laboratory findings, chest radiography, pulmonary and cardiac ultrasound and high resolution computed tomography. His recovery was uneventful. The pathophysiology of bilateral RPE is not well known. Treatment is mainly supportive and consists of diuretics, mechanical ventilation, inotropes and steroids. In case of a pulmonary deterioration after the drainage of a traumatic pneumothorax, bilateral RPE should be considered after exclusion of more common causes of dyspnea.

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