"I" . . "acute respiratory failure; pneumothorax; reexpansion pulmonary oedema"@en . . . "Reexpansion pulmonary oedema after drainage of a long-term spontaneous pneumothorax - a case report"@en . "[94BEF9641BF1]" . "Lischke, Robert" . "RIV/00064203:_____/13:10188974" . . . "RIV/00064203:_____/13:10188974!RIV14-MZ0-00064203" . "Reexpansion pulmonary oedema after drainage of a long-term spontaneous pneumothorax - a case report"@en . "Reexpanzn\u00ED plicn\u00ED ed\u00E9m (RPE) je vz\u00E1cn\u00E1, ale potenci\u00E1ln\u011B let\u00E1ln\u00ED komplikace hrudn\u00ED dren\u00E1\u017Ee pro pneumotorax. Morbidita a mortalita RPE jsou vysok\u00E9, a\u017E 20 % p\u0159\u00EDpad\u016F kon\u010D\u00ED smrt\u00ED, proto si zasluhuje na\u0161i pozornost. Uv\u00E1d\u00EDme kazuistiku ipsilater\u00E1ln\u00EDho levostrann\u00E9ho ed\u00E9mu po zaveden\u00ED hrudn\u00EDho dr\u00E9nu u 42let\u00E9ho mu\u017Ee se spont\u00E1nn\u00EDm pneumotoraxem. M\u016F\u017Eeme p\u0159edpokl\u00E1dat trv\u00E1n\u00ED pneumotoraxu a\u017E 3 t\u00FDdny (od prvn\u00ED prezentace n\u00E1hl\u00E9 du\u0161nosti a bolesti na hrudi). Patofyziologie tohoto plicn\u00EDho posti\u017Een\u00ED nebyla zat\u00EDm zcela objasn\u011Bna, ale pravd\u011Bpodobn\u011B hlavn\u00ED roli v rozvoji RPE hraje po\u0161kozen\u00ED endotelu, kter\u00E9 je n\u00E1sledov\u00E1no zv\u00FD\u0161enou endoteli\u00E1ln\u00ED permeabilitou b\u011Bhem ischemicko-reperfuzn\u00EDho poran\u011Bn\u00ED pl\u00EDce. Hlavn\u00ED rizikov\u00E9 faktory pro rozvoj RPE jsou mlad\u0161\u00ED v\u011Bk (\u010D\u00EDm mlad\u0161\u00ED pacient, t\u00EDm v\u011Bt\u0161\u00ED riziko), \u017Eensk\u00E9 pohlav\u00ED, velikost kolapsu pl\u00EDce, pneumotorax trvaj\u00EDc\u00ED d\u00E9le ne\u017E 24 hodin, reexpanze pl\u00EDce do deseti minut, pou\u017Eit\u00ED aktivn\u00EDho s\u00E1n\u00ED a v p\u0159\u00EDpad\u011B fluidotoraxu evakuace v\u00EDce ne\u017E 2000 ml v\u00FDpotku. U pacient\u016F s t\u011Bmito rizikov\u00FDmi faktory nen\u00ED vhodn\u00E9 inici\u00E1ln\u011B u\u017E\u00EDt dren\u00E1\u017Ee s aktivn\u00EDm s\u00E1n\u00EDm, p\u0159esto je tento postup v \u010CR b\u011B\u017En\u00FD. Hrudn\u00ED chirurgov\u00E9 u\u017E\u00EDvaj\u00ED podtlakov\u00E9 dren\u00E1\u017Ee \u010Dast\u011Bji ne\u017E pneumologov\u00E9 (70 % versus 52 %). Manifestace rozv\u00EDjej\u00EDc\u00EDho se RPE kol\u00EDs\u00E1 od benign\u00EDho klinick\u00E9ho pr\u016Fb\u011Bhu (pacient bez subjektivn\u00EDch obt\u00ED\u017E\u00ED, ale s n\u00E1lezem charakteristick\u00FDm pro RPE na RTG plic) a\u017E k potenci\u00E1ln\u011B let\u00E1ln\u00EDmu pr\u016Fb\u011Bhu s rychle progreduj\u00EDc\u00EDm respira\u010Dn\u00EDm selh\u00E1n\u00EDm. U v\u011Bt\u0161iny pacient\u016F se RPE vyvine b\u011Bhem prvn\u00ED hodiny reexpanze a posti\u017Eena je ipsilater\u00E1ln\u00ED pl\u00EDce. Jen velmi vz\u00E1cn\u011B m\u016F\u017Ee b\u00FDt plicn\u00ED ed\u00E9m bilatel\u00E1rn\u00ED \u010Di kontralatel\u00E1rn\u00ED. L\u00E9\u010Dba RPE je podp\u016Frn\u00E1 a \u0159\u00EDd\u00ED se dle individu\u00E1ln\u00EDho stavu pacienta, od pouh\u00E9ho monitorov\u00E1n\u00ED a\u017E po um\u011Blou plicn\u00ED ventilaci u z\u00E1va\u017En\u011Bj\u0161\u00EDch p\u0159\u00EDpad\u016F respira\u010Dn\u00EDho selh\u00E1n\u00ED. Zlat\u00FDm standardem v l\u00E9\u010Db\u011B RPE z\u016Fst\u00E1v\u00E1 mechanick\u00E1 ventilace s pozitivn\u00EDm tlakem na konci exspiria (PEEP)."@cs . . "92" . "0035-9351" . . "Reexpanzn\u00ED plicn\u00ED ed\u00E9m (RPE) je vz\u00E1cn\u00E1, ale potenci\u00E1ln\u011B let\u00E1ln\u00ED komplikace hrudn\u00ED dren\u00E1\u017Ee pro pneumotorax. Morbidita a mortalita RPE jsou vysok\u00E9, a\u017E 20 % p\u0159\u00EDpad\u016F kon\u010D\u00ED smrt\u00ED, proto si zasluhuje na\u0161i pozornost. Uv\u00E1d\u00EDme kazuistiku ipsilater\u00E1ln\u00EDho levostrann\u00E9ho ed\u00E9mu po zaveden\u00ED hrudn\u00EDho dr\u00E9nu u 42let\u00E9ho mu\u017Ee se spont\u00E1nn\u00EDm pneumotoraxem. M\u016F\u017Eeme p\u0159edpokl\u00E1dat trv\u00E1n\u00ED pneumotoraxu a\u017E 3 t\u00FDdny (od prvn\u00ED prezentace n\u00E1hl\u00E9 du\u0161nosti a bolesti na hrudi). Patofyziologie tohoto plicn\u00EDho posti\u017Een\u00ED nebyla zat\u00EDm zcela objasn\u011Bna, ale pravd\u011Bpodobn\u011B hlavn\u00ED roli v rozvoji RPE hraje po\u0161kozen\u00ED endotelu, kter\u00E9 je n\u00E1sledov\u00E1no zv\u00FD\u0161enou endoteli\u00E1ln\u00ED permeabilitou b\u011Bhem ischemicko-reperfuzn\u00EDho poran\u011Bn\u00ED pl\u00EDce. Hlavn\u00ED rizikov\u00E9 faktory pro rozvoj RPE jsou mlad\u0161\u00ED v\u011Bk (\u010D\u00EDm mlad\u0161\u00ED pacient, t\u00EDm v\u011Bt\u0161\u00ED riziko), \u017Eensk\u00E9 pohlav\u00ED, velikost kolapsu pl\u00EDce, pneumotorax trvaj\u00EDc\u00ED d\u00E9le ne\u017E 24 hodin, reexpanze pl\u00EDce do deseti minut, pou\u017Eit\u00ED aktivn\u00EDho s\u00E1n\u00ED a v p\u0159\u00EDpad\u011B fluidotoraxu evakuace v\u00EDce ne\u017E 2000 ml v\u00FDpotku. U pacient\u016F s t\u011Bmito rizikov\u00FDmi faktory nen\u00ED vhodn\u00E9 inici\u00E1ln\u011B u\u017E\u00EDt dren\u00E1\u017Ee s aktivn\u00EDm s\u00E1n\u00EDm, p\u0159esto je tento postup v \u010CR b\u011B\u017En\u00FD. Hrudn\u00ED chirurgov\u00E9 u\u017E\u00EDvaj\u00ED podtlakov\u00E9 dren\u00E1\u017Ee \u010Dast\u011Bji ne\u017E pneumologov\u00E9 (70 % versus 52 %). Manifestace rozv\u00EDjej\u00EDc\u00EDho se RPE kol\u00EDs\u00E1 od benign\u00EDho klinick\u00E9ho pr\u016Fb\u011Bhu (pacient bez subjektivn\u00EDch obt\u00ED\u017E\u00ED, ale s n\u00E1lezem charakteristick\u00FDm pro RPE na RTG plic) a\u017E k potenci\u00E1ln\u011B let\u00E1ln\u00EDmu pr\u016Fb\u011Bhu s rychle progreduj\u00EDc\u00EDm respira\u010Dn\u00EDm selh\u00E1n\u00EDm. U v\u011Bt\u0161iny pacient\u016F se RPE vyvine b\u011Bhem prvn\u00ED hodiny reexpanze a posti\u017Eena je ipsilater\u00E1ln\u00ED pl\u00EDce. Jen velmi vz\u00E1cn\u011B m\u016F\u017Ee b\u00FDt plicn\u00ED ed\u00E9m bilatel\u00E1rn\u00ED \u010Di kontralatel\u00E1rn\u00ED. L\u00E9\u010Dba RPE je podp\u016Frn\u00E1 a \u0159\u00EDd\u00ED se dle individu\u00E1ln\u00EDho stavu pacienta, od pouh\u00E9ho monitorov\u00E1n\u00ED a\u017E po um\u011Blou plicn\u00ED ventilaci u z\u00E1va\u017En\u011Bj\u0161\u00EDch p\u0159\u00EDpad\u016F respira\u010Dn\u00EDho selh\u00E1n\u00ED. Zlat\u00FDm standardem v l\u00E9\u010Db\u011B RPE z\u016Fst\u00E1v\u00E1 mechanick\u00E1 ventilace s pozitivn\u00EDm tlakem na konci exspiria (PEEP)." . . . "Stolz, Alan" . . . . "Reexpanzn\u00ED ed\u00E9m pl\u00EDce po dren\u00E1\u017Ei dlouhotrvaj\u00EDc\u00EDho spont\u00E1nn\u00EDho pneumotoraxu - kazuistika"@cs . . . "Rozhledy v chirurgii" . "101883" . "My\u0161\u00EDkov\u00E1, Dagmar" . . "Reexpanzn\u00ED ed\u00E9m pl\u00EDce po dren\u00E1\u017Ei dlouhotrvaj\u00EDc\u00EDho spont\u00E1nn\u00EDho pneumotoraxu - kazuistika"@cs . "CZ - \u010Cesk\u00E1 republika" . "4"^^ . . "Reexpanzn\u00ED ed\u00E9m pl\u00EDce po dren\u00E1\u017Ei dlouhotrvaj\u00EDc\u00EDho spont\u00E1nn\u00EDho pneumotoraxu - kazuistika" . "6" . "eexpansion pulmonary oedema is a rare but possibly lethal complication of thoracic drainage for pneumothorax. Morbidity and mortality of this complication remains high (up to 20% of lethal cases) and as such deserves our attention. We report a case of ipsilateral left-sided pulmonary oedema following chest tube insertion in a 42-year-old male patient with spontaneous pneumothorax. Pneumothorax can be expected to last for up to 3 weeks (from the first presentation of sudden dyspnoea and chest pain). The pathophysiology of this lung affection has not yet been completely elucidated; the crucial role is probably played by damage to the endothelium which is followed by increased endothelial permeability during ischemia-reperfusion injury in a rapidly reexpanding lung. The main risk factors for the development of RPE are young age (the younger the patient, the higher the risk), the female sex, the degree of lung collapse, a pneumothorax that lasts more than 24 hours, a reexpansion of the lung in less than ten minutes, the use of a suction system, and - in cases of a pleural effusion - an evacuation volume of more than 2000 ml. Although in patients with these risk factors the administration of initial negative pressure should be avoided, this procedure remains common practice in pneumothorax treatment in the Czech Republic. Thoracic surgeons are more likely to use the suction system than pulmonologists (70% versus 52%). RPE manifestation ranges from benign clinical course (patients are free of complaints with only pathological chest radiography findings) to potentially lethal rapid respiratory failure with circulatory shock. Most patients develop RPE within 1 hour of expansion and the ipsilateral lung is affected. Only rarely can pulmonary oedema be bilateral, or in the contra-lateral lung. Treatment of RPE is supportive and depends on the individual patient's condition, ranging from mere monitoring to mechanical ventilation for serious cases."@en . "Reexpanzn\u00ED ed\u00E9m pl\u00EDce po dren\u00E1\u017Ei dlouhotrvaj\u00EDc\u00EDho spont\u00E1nn\u00EDho pneumotoraxu - kazuistika" . . "4"^^ . . "http://www.prolekare.cz/rozhledy-v-chirurgii-clanek/reexpanzni-edem-plice-po-drenazi-dlouhotrvajiciho-spontanniho-pneumotoraxu-kazuistika-41297" . "4"^^ . "\u0160imonek, Jan" .