A case of reexpansion pulmonary edema and acute pulmonary thromboembolism associated with diffuse large B-cell lymphoma treated with venovenous extracorporeal membrane oxygenation
| Autor: | Toyoaki Murohara, Yukari Goto, Yasuko K Bando, Takahiko Sato, Tasuku Kuwayama, Naoyuki Matsuda, Masayuki Ozaki, Daisuke Kasugai, Kenji Furusawa, Reina Ozaki, Yuma Yasuda, Toru Kondo, Yoshihito Arao, Michiko Higashi, Hideo Oishi, Hiroaki Hiraiwa, Takahiro Okumura, Shingo Kazama, Naruhiro Jingushi, Hiroo Kato, Hitoshi Kiyoi, Atsushi Numaguchi, Kazuyuki Shimada, Takanori Yamamoto, Yuki Kimura, Naoki Shibata, Genki Nakamura, Hiroaki Ogawa, Shogo Yamaguchi, Ryota Morimoto |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Lung business.industry Pleural effusion medicine.medical_treatment Case Report 030204 cardiovascular system & hematology medicine.disease Pulmonary edema Right pulmonary artery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Effusion Respiratory failure Internal medicine Extracorporeal membrane oxygenation medicine Cardiology 030212 general & internal medicine Thrombus Cardiology and Cardiovascular Medicine business |
| Zdroj: | J Cardiol Cases |
| ISSN: | 1878-5409 |
| DOI: | 10.1016/j.jccase.2020.08.013 |
| Popis: | A 37-year-old man diagnosed with diffuse large B-cell lymphoma two weeks previously, visited our emergency department with sudden dyspnea. He had a severe respiratory failure with saturated percutaneous oxygen at 80% (room air). Chest radiography showed a large amount of left pleural effusion. After 1000 mL of the effusion was urgently drained, reexpansion pulmonary edema (RPE) occurred. Despite ventilator management, oxygenation did not improve and venovenous extracorporeal membrane oxygenation (VV-ECMO) was initiated in the intensive care unit. The next day, contrast-enhanced computed tomography showed a massive thrombus in the right pulmonary artery, at this point the presence of pulmonary thromboembolism (PTE) was revealed. Fortunately, the patient’s condition gradually improved with anticoagulant therapy and VV-ECMO support. VV-ECMO was successfully discontinued on day 4, and chemotherapy was initiated on day 8. We speculated the following mechanism in this case: blood flow to the right lung significantly reduced due to acute massive PTE, and blood flow to the left lung correspondingly increased, which could have caused RPE in the left lung. Therefore, our observations suggest that drainage of pleural effusion when contralateral blood flow is impaired due to acute PTE may increase the risk of RPE. |
| Databáze: | OpenAIRE |
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