Evidence for increased permeability in reexpansion pulmonary edema

doi:10.1016/0002-9343(81)90188-1

The American Journal of Medicine

Volume 71, Issue 3, September 1981, Pages 497-500

https://doi.org/10.1016/0002-9343(81)90188-1 Get rights and content

Abstract

Concurrent analyses of the colloid osmotic pressure of pulmonary edema fluid and serum were performed in two patients with reexpansion pulmonary edema. In addition, pulmonary artery wedge pressure was measured during pulmonary edema in one patient. The colloid osmotic pressure of the pulmonary edema fluid was 73 and 81 percent of the serum value. The pulmonary arterial wedge pressure in one patient was within normal limits (8 mm Hg). Reexpansion pulmonary edema appears to be due to increased pulmonary capillary permeability rather than to hemodynamic mechanisms.

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In minimally invasive cardiac surgery procedures, longer CPB, pre-existing COPD, and pre-existing pulmonary hypertension or significant right ventricular dysfunction are considered independent risk factors of unilateral postoperative pulmonary edema.12 Although the pathophysiology of REPE is complex and still not completely characterized, increased pulmonary capillary permeability induced by pulmonary microvessel injury has been suggested as a major mechanism.6,13–16 In chronic lung collapse, the pulmonary capillary endothelium and basement membrane are thickened by anoxic and mechanical stress, which hardens the pulmonary microvessels and diminishes vessel flexibility.
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^☆: This paper was supported by the Veterans Administration.

¹: From the Department of Medicine, Divisions of General Medicine and Pulmonary Diseases, Veterans Administration Medical Center, Jackson Memorial Hospital, University of Miami School of Medicine.

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Case reportEvidence for increased permeability in reexpansion pulmonary edema☆

Abstract

Radiology

Ann Thorac Surg

Chest

Am Rev Respir Dis

Pulmonary edema

N Engl J Med

Pulmonary edema

N Engl J Med

Pulmonary edema following the rapid reexpansion of a totally collapsed lung due to a pneumothorax

Acute pulmonary edema following the treatment of spontaneous pneumothorax with excessive negative intrapleural pressure

Am Rev Respir Dis

Unilateral pulmonary edema after pleural aspiration

Lancet

Unilateral pulmonary edema resulting from treatment of spontaneous pneumothorax

Am Rev Respir Dis

Case report
Evidence for increased permeability in reexpansion pulmonary edema☆