High-flow oxygen therapy for treating re-expansion pulmonary edema

Sang Kwon Lee, Bong Soo Son, Joohyung Son, Seung Eun Lee, Hye Ju Yeo, Do Hyung Kim


Re-expansion pulmonary edema (REPE) is a lethal complication, which usually occurs after rapid re-expansion of a collapsed lung following chest tube insertion. As REPE can induce respiratory failure, mechanical ventilation is necessary in some cases. However, ventilator therapy can worsen ventilation perfusion mismatch at the initial stage of the treatment procedure, and increases the risk of fatality. To resolve this problem, it is advisable to maintain spontaneous breathing without using a mechanical ventilator. A high-flow nasal cannula can supply a high concentration of oxygen while maintaining spontaneous breathing in patients with dyspnea, which has recently emerged as an alternative to ventilators. We introduced a high-flow nasal cannula to treat REPE instead of a mechanical ventilator and successfully treated a patient with severe REPE.