Re-Expansion Pulmonary Edema vs Alveolar-Pleural Fistula During Liver Transplant: Diagnosis and Management
A 46-year-old man with a history of nonalcoholic fatty liver cirrhosis and acute kidney injury secondary to hepatorenal syndrome presented for liver transplant. The patient had a right hepatic hydrothorax with a Pleurx catheter placement and had been draining 500cc fluid three-times per week prior to surgery. Prior to induction, the catheter drained out 1L of fluid which progressed to 300cc of frothy yellow/brown secretions after induction and resulted in 14L in total throughout the operative period. This case will be used to discuss an algorithm for diagnosing re-expansion pulmonary edema and alveolar-pleural fistula while proposing management of both scenarios.
Khatter N, Brockberg MS, Al-Attar NC, Mahmoud SA. Re-expansion pulmonary edema vs alveolar-pleural fistula during liver transplant: diagnosis and management. Presented at: American Society of Anesthesiologists Annual Meeting; 2023 Oct 14; San Francisco, CA.