Pulmonary edema may rarely occur in a patient following the re-expansion of a collapsed lung due to pneumothorax or pleural effusion. The disorder is associated with significant morbidity and mortality, so patients should be monitored closely and treated aggressively.


Preceding conditions:

(1) pneumothorax

(2) large pleural effusion

(3) atelectasis


Clinical features:

(1) usually unilateral, but may be bilateral

(2) the edema is usually ipsilateral to the collapsed lung, but may be contralateral

(3) the lung collapse is usually chronic in duration, but may be acute

(4) the condition may be more frequent with rapid lung expansion or high negative intrapleural pressures, but may occur without suction

(5) onset is usually immediate or within an hour, but may delayed for up to 12 hours

(6) onset may be dramatic

(7) symptoms may range from mild to severe

(8) usually self-limited, with symptoms tending to regress after 48 hours


Signs and symptoms:

(1) cough

(2) feelings of chest tightness

(3) hypoxemia which may progress to respiratory failure

(4) hypotension which may progress to shock

(5) sputum production, which may be frothy


Certainty in the diagnosis is helped if there is no concurrent condition that could explain the edema and if it is unilateral.


To read more or access our algorithms and calculators, please log in or register.