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Published in: Intensive Care Medicine 1/2007

01-01-2007 | Correspondence

Lateral decubitus position for life-threatening postpneumonectomy pulmonary edema

Authors: Jean-Christophe Farkas, Bruno Lafon, Michel Monteau, Gerard Bonnaud

Published in: Intensive Care Medicine | Issue 1/2007

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Excerpt

Sir: Postpneumonectomy pulmonary edema (PPE) has an incidence of 2.5–13.5%, with an overall mortality of 50%–100% [1, 2, 3, 4]. There is no specific treatment for PPE. We describe three consecutive cases of life-threatening hypoxemia occurring during PPE successfully managed with lateral decubitus (LD), with the remaining lung placed uppermost. The ventilatory and hemodynamic parameters of these three patients are reported in Table 1.
Table 1
Ventilatory and hemodynamic parameters. Abbreviations: RR respiratory rate, Vt tidal volume (ml/kg), PlatP plateau pressure, MAP mean arterial pressure, NorEp norepinephrine μg/kg/min; PaO2, PaCO2 and MAP in mmHg, plateau pressure and PEEP in cmH2O
Time
Position
RR
Vt
PlatP
FiO2
PaO2
PaCO2
PEEP
MAP
NorEp
Patient 1
                   
Admission
Supine
25
6.1
30
100
50
57
5
88
H+9
Supinea
25
4.9
29
100
54
68
10
89
H+13
Lateral
25
4.9
29
100
432
72
10
70
H+24
Lateral
25
4.2
24
70
165
64
10
80
H+48
Lateral
25
4.2
22
60
241
64
10
66
Patient 2
                   
Admission
Supine
20
5
100
78
72
10
66
H+18
Supinea
20
5
28
100
79
75
8
61
H+19
Lateral
20
5
28
100
389
80
8
61
H+48
Lateral
20
5
22
70
196
72
8
89
0.5
H+72
Lateral
22
5
18
60
82
62
8
76
0.5
Patient 3
                   
Admission
Supine
25
6.7
35
100
85
45
6
89
H+2
Supinea
25
6.1
32
100
58
57
10
81
H+3
Lateral
20
5.9
25
100
414
55
10
73
H+24
Lateral
20
5.4
27
60
153
53
10
79
0.1
H+48
Lateral
25
5.3
25
60
190
55
10
80
0.1
a The patients were then placed in lateral decubitus
Literature
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2.
go back to reference van der Werff YD, van der Houwen HK, Heijmans PJ, Duurkens VA, Leusink HA, van Heesewijk HP, de Boer A (1997) Postpneumonectomy pulmonary edema. A retrospective analysis of incidence and possible risk factors. Chest 111:1278–1284PubMed van der Werff YD, van der Houwen HK, Heijmans PJ, Duurkens VA, Leusink HA, van Heesewijk HP, de Boer A (1997) Postpneumonectomy pulmonary edema. A retrospective analysis of incidence and possible risk factors. Chest 111:1278–1284PubMed
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Metadata
Title
Lateral decubitus position for life-threatening postpneumonectomy pulmonary edema
Authors
Jean-Christophe Farkas
Bruno Lafon
Michel Monteau
Gerard Bonnaud
Publication date
01-01-2007
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 1/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-006-0420-2

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