CATASTROPHIC CIRCULATORY COLLAPSE FOLLOWING REEXPANSION PULMONARY-EDEMA

Re-expansion pulmonary oedema is a recognised but rare complication fo llowing the rapid drainage of a large pleural effusion or pneumothorax [1,2], usually occurring on the side of re-inflation. The pathogenesi s of the pulmonary oedema is poorly understood but is thought to be du e to micro-vascular shearing resulting in neutrophil activation and ad hesion to the vascular endothelium resulting in increased micro-vascul ar permeability [3-7]. Few reports appear in the literature of invasiv e haemodynamic monitoring following this catastrophe. We describe a pa tient who sustained fatal pulmonary oedema arising in the contralatera l lung, with pulmonary flow catheter data documenting the initial circ ulatory collapse following the aspiration of a massive pulmonary effus ion.