Anzeige
Erschienen in:
01.01.2007 | Correspondence
Lateral decubitus position for life-threatening postpneumonectomy pulmonary edema
Erschienen in: Intensive Care Medicine | Ausgabe 1/2007
Einloggen, um Zugang zu erhaltenExcerpt
Sir: Postpneumonectomy pulmonary edema (PPE) has an incidence of 2.5–13.5%, with an overall mortality of 50%–100% [1, 2, 3, 4]. There is no specific treatment for PPE. We describe three consecutive cases of life-threatening hypoxemia occurring during PPE successfully managed with lateral decubitus (LD), with the remaining lung placed uppermost. The ventilatory and hemodynamic parameters of these three patients are reported in Table 1.
Table 1
Ventilatory and hemodynamic parameters. Abbreviations: RR respiratory rate, Vt tidal volume (ml/kg), PlatP plateau pressure, MAP mean arterial pressure, NorEp norepinephrine μg/kg/min; PaO2, PaCO2 and MAP in mmHg, plateau pressure and PEEP in cmH2O
|
Time
|
Position
|
RR
|
Vt
|
PlatP
|
FiO2
|
PaO2
|
PaCO2
|
PEEP
|
MAP
|
NorEp
|
|---|---|---|---|---|---|---|---|---|---|---|
|
Patient 1
|
||||||||||
|
Admission
|
Supine
|
25
|
6.1
|
30
|
100
|
50
|
57
|
5
|
88
|
–
|
|
H+9
|
Supinea
|
25
|
4.9
|
29
|
100
|
54
|
68
|
10
|
89
|
–
|
|
H+13
|
Lateral
|
25
|
4.9
|
29
|
100
|
432
|
72
|
10
|
70
|
–
|
|
H+24
|
Lateral
|
25
|
4.2
|
24
|
70
|
165
|
64
|
10
|
80
|
–
|
|
H+48
|
Lateral
|
25
|
4.2
|
22
|
60
|
241
|
64
|
10
|
66
|
–
|
|
Patient 2
|
||||||||||
|
Admission
|
Supine
|
20
|
5
|
–
|
100
|
78
|
72
|
10
|
66
|
–
|
|
H+18
|
Supinea
|
20
|
5
|
28
|
100
|
79
|
75
|
8
|
61
|
–
|
|
H+19
|
Lateral
|
20
|
5
|
28
|
100
|
389
|
80
|
8
|
61
|
–
|
|
H+48
|
Lateral
|
20
|
5
|
22
|
70
|
196
|
72
|
8
|
89
|
0.5
|
|
H+72
|
Lateral
|
22
|
5
|
18
|
60
|
82
|
62
|
8
|
76
|
0.5
|
|
Patient 3
|
||||||||||
|
Admission
|
Supine
|
25
|
6.7
|
35
|
100
|
85
|
45
|
6
|
89
|
–
|
|
H+2
|
Supinea
|
25
|
6.1
|
32
|
100
|
58
|
57
|
10
|
81
|
–
|
|
H+3
|
Lateral
|
20
|
5.9
|
25
|
100
|
414
|
55
|
10
|
73
|
–
|
|
H+24
|
Lateral
|
20
|
5.4
|
27
|
60
|
153
|
53
|
10
|
79
|
0.1
|
|
H+48
|
Lateral
|
25
|
5.3
|
25
|
60
|
190
|
55
|
10
|
80
|
0.1
|