Adult respiratory distress syndrome complicating percutaneous nephrolithotripsy

In an otherwise healthy thirty-six-year-old man adult respiratory distress syndrome developed following percutaneous nephrolithotripsy. Absorption of a large volume of irrigating solution occurred during the procedure and resulted in respiratory compromise, neither of which was appreciated intraoperatively. Close intraoperative monitoring of irrigation fluid input and output is necessary, and if a significant discrepancy develops, we believe the procedure should be terminated and diuresis instituted. In a difficult procedure, consideration should be given to establishing a maximum operating time and shortened if patient risk factors so warrant.