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. 2014 Sep;6(9):1187-92.
doi: 10.3978/j.issn.2072-1439.2014.07.35.

An analysis of and new risk factors for reexpansion pulmonary edema following spontaneous pneumothorax

Naohiro Taira  1 , Tsutomu Kawabata  1 , Takaharu Ichi  1 , Tomofumi Yohena  1 , Hidenori Kawasaki  1 , Kiyoshi Ishikawa  1
Affiliations

An analysis of and new risk factors for reexpansion pulmonary edema following spontaneous pneumothorax

Naohiro Taira et al. J Thorac Dis. 2014 Sep.

Abstract

Background: The major risk factor for reexpansion pulmonary edema (RPE) following the treatment of spontaneous pneumothorax is thought to be chronic lung collapse. However, a long-term collapsed lung does not always cause RPE. The purpose of this study was to define other risk factors for RPE among patients undergoing drainage for the treatment of spontaneous pneumothorax.

Methods: We retrospectively reviewed all the patients with spontaneous pneumothorax who had been treated at our hospital during a 5-year period. The duration of symptoms, location and size of the pneumothorax, size of the chest tube, and pleural effusion, which can occur coincidentally with pneumothorax, were compared in patients who did and did not experience RPE.

Results: Forty patients were underwent drainage for the treatment of a spontaneous pneumothorax between January 2007 and December 2012. RPE developed in 13 of the 40 (32.5%) patients. In the multivariate analysis, the presence of pleural effusion coincident with pneumothorax contributed to the risk for RPE [odds ratios (OR), 1.557; 95% confidence intervals (CI), 1.290-1.880]. The duration of symptoms, location and size of the pneumothorax and size of the chest tube were similar between the groups. Symptomatic RPE was associated with a larger pneumothorax size.

Conclusions: The rate of RPE following spontaneous pneumothorax is higher than was previously reported. Our findings suggest the presence of pleural effusion coincidentally with pneumothorax may therefore be a new risk factor for RPE.

Keywords: Lung; pneumothorax.

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Figures

Figure 1
Figure 1
Representative chest radiographs and CT scan of a pneumothorax that was associated with the development of asymptomatic RPE (A) and symptomatic RPE (B). Both figures show X-rays of pleural effusion (white arrow) in addition to pneumothorax (left column). Both of the X-rays taken after tube thoracostomy reveals a hazy ground-glass infiltrate in the left lower-lobe (middle column). Right column indicates CT images of RPE (black allow); RPE, reexpansion pulmonary edema.
See this image and copyright information in PMC

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