저자 등은 다량의 흉막유출로 반대측 폐의 일부 허탈과 폐부종을 보이는 만성 간질환 환자의 호흡곤란의 경감을 위하여 시행한 흉강천자 후 발생한 양측성 재팽창성 폐부종(reexpansion pulmonary edema)과 이로 인한 급성호흡곤란증후군을 경험하고 이를 문헌고찰과 함께 보고하는 바이다.
Acute bilateral reexpansion pulmonary edema after pleurocentesis is a rare complication. In one case, bilateral reexpansion pulmonary edema after unilateral pleurocentensis in sarcoma was reported. Various hypotheses regarding the mechanism of reexpansion pulmonary edema include increased capillary permeability due to hypoxic injury, decreased surfactant production, altered pulmonary perfusion and mechanical stretching of the membranes. Ragozzino et al suggested that the mechanism leading to unilateral reexpansion pulmonary edema involves the opposite lung when there is significant contralateral lung compression. Here we report a case of bilateral reexpansion pulmonary edema and acute respiratory distress syndrome after a unilateral pleurocentesis of a large pleural effusion with contralateral lung compression and increased interstitial lung marking underlying chronic liver disease.
