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Reexpansion pulmonary edema in children

Antonio Lucas L Rodrigues1, Carlos Eduardo Lopes, Mariana Tresoldi das N Romaneli

  • 1Unicamp, Faculdade de Ciências Médicas, Departamento de Pediatria, CampinasSP, Brasil.

Revista Paulista De Pediatria : Orgao Oficial Da Sociedade De Pediatria De Sao Paulo
|October 22, 2013
PubMed

Insights

Reexpansion pulmonary edema is a rare, fatal complication of pleural effusion treatment. Slow fluid evacuation, limiting drainage to 1,500 mL at once, can help prevent this serious condition.

Area of Science:

  • Medicine
  • Pulmonology
  • Critical Care

Background:

  • Pleural effusion in children can be challenging to manage.
  • Reexpansion pulmonary edema (RPE) is a rare but potentially fatal complication following pleural fluid evacuation.

Observation:

  • An 11-year-old boy with large pleural effusion developed acute respiratory insufficiency post-tube thoracostomy.
  • Clinical course included mechanical ventilation and atypical recovery, with CT findings consistent with RPE.

Findings:

  • The patient's condition improved with intensive care, and subsequent diagnosis was pleural tuberculosis.
  • This case highlights the rarity of RPE in pediatric patients, with only five previous reports.

Implications:

  • Physicians should be aware of RPE as a potential complication in pediatric pleural effusion management.
  • Recommendations include slow evacuation of pleural fluid, not exceeding 1,500 mL at a time, to mitigate mortality risk.

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