A Successful Experience for the Reversal of Acute Respiratory Failure Ascribable to Re-expansion Pulmonary Edema Via Extracorporeal Membrane Oxygenation Therapy: A Case Report and Review of the Current Literature

自發性血胸病患在胸腔鏡手術後發生再張性肺水腫繼而引起急性呼吸衰竭：使用體外葉克膜維生系統之經驗－病例報告及文獻回顧

張錦新(Kam-Sun Cheung) ； 馬振來(Chun-Lai Ma) ； 陳燿舜(Yiu-Sion Chen) ； 童詠偉(Yung-Wei Tung) ； 吳清文(Ching-Wen Wu)

《童綜合醫學雜誌》 2卷2期 (2008/12) Pp. 95-99

https://doi.org/10.29838/TMJ.200812.0007

摘要

再張性肺水腫是一種罕見的手術後併發症，如果沒有早期的診斷及有效的治療，它是會危及生命。其繼發生於任何原因所致的肺部擴張不全之後，在肺部再膨脹時或擴張後發生急性肺水腫，多見於治療氣胸後或單側肺部麻醉之後再膨脹時。我們報告一位16歲男性因自發性右側大量血胸，在胸腔鏡清除胸腔內血塊後單肺麻醉再膨脹時發生再張性雙側肺水腫合併急性呼吸衰竭。病患生命徵象與血中含氧量在強心劑與呼吸器使用下，仍無法維持穩定情況時，在運用體外葉克膜維生系統治療下，成功搶救病人的生命。臨床上發生再張性肺水腫合併急性呼吸衰竭在常規支持和輔助治療無效後才會考慮使用體外葉克膜維生系統，此技術被認為是一項安全且有效維持生命的臨時救治手段。

關鍵字

再張性肺水腫 ； 體外葉克膜維生系系統 ； 自發性血胸 ； 急性呼吸衰竭

並列摘要

The literature has documented that various clinical conditions including hemopneumothorax, large pleural effusion, pnemothorax,and after lobectomy (or even one-lung ventilation), can lead to re-expansion pulmonary edema (REPE), an uncommon complication and yet potentially life-threatening condition.We describe herein a successful experience for the reversal of post-operative REPE case associated with video-assisted thoracoscopic surgery of massive spontaneous hemothorax due to acute hypovolemia occurred following the evacuation of an hemothorax with rapid re-expansion of a collapsed lung. This patient was successfully treated by application of extracorporeal membrane oxygenation (ECMO).

並列關鍵字

Reexpansion Pulmonary Edema ； Extracorporeal Membrane Oxgenation ； Spontaneous Hemothorax ； Acute Respiratory Failure