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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.
Summary
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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