English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

El “REPE” (Re-expansion Pulmonary Edema) es una complicacion poco comun que puede ocurrir despues del drenaje rapido de un neumotorax o de abundante liquido pleural (1,2). La incidencia en adultos es del el 0-1%. Su mortalidad puede alcanzar  el 20% (1,3). Las hipotesis propuestas para el desarrollo de dicha entidad incluyen, el aumento de la permeabilidad de la microvasculatura pulmonar, cambios en el flujo linfatico, disminucion de la produccion de surfactante y aumento de la presion hidrostatica del flujo vascular del pulmon reexpandido (4). Se caracteriza por el desarrollo agudo de hipoxemia refractaria al oxigeno y la aparicion de infiltrados alveolares intersticiales en un plazo de 24 horas tras el drenaje (5). Son factores de riesgo de REPE: la edad comprendida entre los 20 y 40 anos, la duracion del colapso pulmonar mayor de 72 horas, la aplicacion de altas presiones negativas durante la toracocentesis (20 cm H2O), una rapida reexpansion tras drenajes de altos volumenes de liquido pleural (> 1.5 L) o la existencia de factores predisponentes para el edema pulmonar (hipoalbuminemia, estasis en la circulacion pulmonar). ABSTRACT Intraoperative reexpansion pulmonary edema “REPE” following thoracoscopy by one lung ventilation The sudden pulmonar expansion which has remained collapsed among different hours or days, likewise the fast pneumothorax or pleural effusion drainage, can cause a flash or acute edema on the affected lung. It is believed that the rexpansive pulmonary syndrome (REPE), is caused due to an increment in the capillary permeability after being exposed the affected lung to high negative intra-pleural pressure. The ocurrence of REPE is a rare event with most cohort studies reporting an incidence of between 0%- 1%. It may extend with hypoxaemia, hypotension and even cardiac arrest. The treatment of these patients include mechanical ventilation with optimal PEEP levels, the use of vasopressors and an intesive electrolyte resuscitation. We expose the case of a 16 year old patient with mediastinal mass diagnosis and massive left-pleural effusion, where after a thorascocopy for biopsy and pleuritic drainage, it is observed a reexpansion pulmonary edema with respiratory repercussion, haemodynamics and the requirement of endotracheal reintubation.

Edema de reexpansión pulmonar “REPE” intraoperatorio tras toracoscopia mediante ventilación unipulmonar