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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El edema pulmonar postneumonectom&#237;a es una complicaci&#243;n poco frecuente&#44; pero de una gravedad extrema que normalmente conduce a la muerte del paciente&#46; Habitualmente se presenta entre las 24 y 48 horas tras una neumonectom&#237;a que hasta ese momento hab&#237;a evolucionado normalmente&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Sus causas todav&#237;a no est&#225;n claras&#46; Ha sido relacionado con el excesivo aporte de fluidos en el per&#237;odo peroperatorio&#44; pero deben existir otros factores involucrados en su g&#233;nesis&#46; Lo mismo se puede decir sobre su fisiopatolog&#237;a&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Presentamos en caso cl&#237;nico de un paciente al que se practic&#243; neumonectom&#237;a izquierda y que desarroll&#243; presumiblemente este cuadro durante su postoperatorio&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El tratamiento se debe basar fundamentalmente en la prevenci&#243;n&#58; 1&#41; tener cuidado con el aporte peroperatorio de l&#237;quidos&#44; 2&#41; realizar profilaxis antibi&#243;tica y 3&#41; una evaluaci&#243;n cuidadosa de las funciones respiratoria&#44; card&#237;aca y renal del paciente&#46;</p></span>"
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Vol. 25. Issue 4.
Pages 155-157 (May 1989)
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Vol. 25. Issue 4.
Pages 155-157 (May 1989)
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Edema pulmonar postneumonectomia
Pulmonary edema after pneumonectomy
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6026
W. Torre, L. Mínguez, J. Pac, F. Vara, E. Canalís
Servicio de Cirugía Torácica. Hospital de Cruces. Baracaldo, Vizcaya
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Article information

El edema pulmonar postneumonectomía es una complicación poco frecuente, pero de una gravedad extrema que normalmente conduce a la muerte del paciente. Habitualmente se presenta entre las 24 y 48 horas tras una neumonectomía que hasta ese momento había evolucionado normalmente.

Sus causas todavía no están claras. Ha sido relacionado con el excesivo aporte de fluidos en el período peroperatorio, pero deben existir otros factores involucrados en su génesis. Lo mismo se puede decir sobre su fisiopatología.

Presentamos en caso clínico de un paciente al que se practicó neumonectomía izquierda y que desarrolló presumiblemente este cuadro durante su postoperatorio.

El tratamiento se debe basar fundamentalmente en la prevención: 1) tener cuidado con el aporte peroperatorio de líquidos, 2) realizar profilaxis antibiótica y 3) una evaluación cuidadosa de las funciones respiratoria, cardíaca y renal del paciente.

Pulmonary edema after pneumonectomy is an uncommon but extremely severe complication, which usually results in the death of the patient. It commonly develops 24-48 hours after an othervise uneventful pneumonectomy.

Its causes are not yet well known. It has been associated with excessive fluid administration in the perioperative pe-riod, but other factors are probably implicated in its deve-lopment. Similar comments apply to its pathophysiology.

We report a patient who presumably developed this di-sorder during the postoperative period of a left pneumonectomy.

Therapy should be mainly based on prevention: 1) Judicious perioperative fluid administration; 2) Antibiotic prophylaxis; 3) Careful evaluation of the respiratory, cardiac and renal function of the patient.

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Bibliografía
[1.]
W.C. Delarue, H. Echapasse.
International trends in general thoracic surgery.
2, WB Saunders Company, (1986), pp. 459-464
[2.]
L. Verheijen-Breemhaar, J.M. Bogaard, B. Van Den Berg.
Hilvering C. Postpneumonectomy pulmonary edema.
Thorax, 43 (1988), pp. 323-326
[3.]
M.J. Krowka, P.C. Pairolero, V.F. Trastek, S. Payne, P.E. Bernatz.
Cardiac dysrhythmia following pneumonectomy Clinical correlates and prognostic significance.
Chest, 91 (1987), pp. 490-495
[4.]
R.A. Zeldin, D. Normandin, D. Landtwing, R.M. Peters.
Postpneunionectomy pulmonary edema.
J Thorac Cardiovasc Surg, 87 (1984), pp. 359-365
[5.]
C. Witnich, Y. Trudel, A. Zidulka, R. Chu-Jeng-Chiu.
Misleading «pulmonary wedge pressure» after pneumonectomy: its importance in postoperative fluid therapy.
Ann Thorac Surg, 42 (1986), pp. 192-196
[6.]
W.C. Satub.
The hemodynamics of pulmonary edema.
Bull Eur Physiopathol Respir, 22 (1986), pp. 319-322
[7.]
A.G. Little, U.K. Langmuir, A.H. Singer, D.B. Skinner.
Hemodynamic pulmonary edema in dog lungs after contralateral pneumonectomy and mediastinal lymphatic interruption.
Lung, 162 (1984), pp. 139-145
Copyright © 1989. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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