A Case of Reexpansion Pulmonary Edema Saved by Differential Lung Ventilation.
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概要
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We experienced a case of severe reexpansion pulmonary edema following rapid reexpansion of a collapsed lung due to spontaneous pneumothorax of 3 weeks duration. Following the reexpansion, the patient developed acute respiratory failure, shock and disseminated intravascular coagulopathy. Conventional mechanical ventilation couldn't improve PaO2 and PaCO2, because of increased dead space ventilation and increased pulmonary shunt flow. The etiology of shock was thought to be hypovolemia due to increased permeability of the capillaries of the reexpanded lung and to be the depression of the cardiac contractility due to hypoxia and acidosis. And the etiology of the edema seemed to be due to impairment of the basement membrane of the pulmonary capil-laries. Differential lung ventilation was applied. It rapidly improved PaO2 and PaCO2, then he recovered from the shock. Differential lung ventilation is very effective for reexpansion pulmonary edema which can't be treated by conventional mechanical ventilation.
- 日本臨床麻酔学会の論文
日本臨床麻酔学会 | 論文
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