Postpneumonectomy pulmonary edema. A retrospective analysis of associated variables

Chest. 1993 Jun;103(6):1646-50. doi: 10.1378/chest.103.6.1646.

Abstract

Study objective: Evaluate the correlation between intravenous fluid administration and postpneumonectomy pulmonary edema.

Design: Retrospective chart review.

Setting: Large multispecialty group practice hospital.

Patients: Adults who had a pneumonectomy performed between 1977 and 1988.

Measurements and results: Patients were identified who had postpneumonectomy pulmonary edema (PPE). Fluid administration and fluid balance information was found in records and compared with age- and sex-matched control patients who did not develop PPE. The side of pneumonectomy was noted for patients in each group. Autopsy findings were recorded for patients who died. Twenty-one patients met PPE criteria. No significant difference was found between groups for fluid administration or fluid balance. Patients who had right pneumonectomy had a significantly higher incidence of PPE. Patients with PPE had a 100 percent mortality rate and histologic evidence of the adult respiratory distress syndrome (ARDS) at autopsy.

Conclusions: PPE is caused by noncardiogenic pulmonary edema rather than excess intravenous fluid administration. There is a greater incidence of the syndrome with right pneumonectomy for unknown reasons. The mortality rate is high despite interventions for ARDS.

MeSH terms

  • Aged
  • Central Venous Pressure
  • Female
  • Fluid Therapy / adverse effects
  • Humans
  • Intraoperative Care
  • Male
  • Middle Aged
  • Pneumonectomy / adverse effects*
  • Pulmonary Artery / physiopathology
  • Pulmonary Circulation
  • Pulmonary Edema / etiology*
  • Pulmonary Edema / mortality
  • Pulmonary Edema / physiopathology
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / mortality
  • Retrospective Studies
  • Vascular Resistance