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Unilateral pulmonary edema after laparoscopic nephrectomy.
Shreepathi Krishna Achar1, Cherish Paul, Elsa Varghese
1Department of Anaesthesiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Journal of Anaesthesiology, Clinical Pharmacology
|November 19, 2011
Summary
This case report details a rare instance of unilateral-dependent pulmonary edema following laparoscopic non-donor nephrectomy. Prompt treatment with noninvasive ventilation, diuretics, and oxygen led to patient recovery.
Area of Science:
- Nephrology
- Pulmonology
- Anesthesiology
Background:
- Laparoscopic donor nephrectomies have been associated with unilateral-dependent pulmonary edema.
- This complication has not been previously documented after laparoscopic non-donor nephrectomies.
Observation:
- A 61-year-old male underwent a 5.75-hour laparoscopic nephrectomy for renal cell carcinoma.
- The patient remained hemodynamically stable, with intra-abdominal pressure <15 mmHg and minimal blood loss.
- Postoperatively, the patient developed respiratory distress and radiological evidence of dependent lung edema.
Findings:
- The patient received 1.5 L Ringer's lactate and 1.0 L 6% hydroxyethyl starch during surgery.
- Postoperative respiratory distress was attributed to unilateral-dependent pulmonary edema.
- Treatment with noninvasive ventilation, diuretics, and oxygen resulted in clinical and radiological improvement.
Implications:
- This case highlights a potential, albeit rare, complication of laparoscopic non-donor nephrectomy.
- Awareness of this complication is crucial for prompt diagnosis and management in the postoperative period.
- Further investigation may be warranted to understand the specific mechanisms contributing to pulmonary edema in this context.
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