Cardiac output increases prior to development of pulmonary edema after re-expansion of spontaneous pneumothorax

Respir Med. 2002 Jun;96(6):461-5. doi: 10.1053/rmed.2002.1301.

Abstract

Pulmonary edema following reexpansion of spontaneous pneumothorax is an uncommon complication. The underlying mechanism of this condition is unclear. We report the hemodynamic characteristics in a series of 7 male patients with spontaneous large (>50%) pneumothoraces of > or = 24 h and correlate the changes with reexpansion pulmonary edema (REPE). A pulmonary artery floatation catheter was inserted and hemodynamic data were obtained before therapeutic chest tube insertion, 1 h after chest tube insertion and the following day. Four (57%) patients developed REPE. There was a tendency for larger pneumothorax to develop REPE. Capillary wedge pressure did not change significantly 1 h after the insertion of chest tube in all our patients. Cardiac output increased significantly in patients who developed REPE compared to those who did not (+ 1.06 l/min vs -0.27 l/min; P = 0.03) 1 h after insertion of chest tube. One patient did not develop pulmonary edema despite having a large (> 80%) pneumothorax. His cardiac output did not rise 1 h after chest tube insertion. REPE is not an uncommon complication following chest tube drainage in patients with large and long-standing pneumothorax. The increase in cardiac output after chest tube insertion may be associated with subsequent development of REPE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cardiac Output / physiology*
  • Chest Tubes / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Pneumothorax / complications*
  • Pneumothorax / physiopathology
  • Pneumothorax / therapy
  • Pulmonary Edema / etiology*
  • Pulmonary Edema / physiopathology
  • Pulmonary Wedge Pressure / physiology