What is re-expansion pulmonary edema and how can it be prevented?

• A. Pulmonary edema occurs with chronic lung disease and cannot be prevented.
• B. Pulmonary edema caused by infection and treated with antibiotics.
• C. Pulmonary edema that occurs after rapid lung re-expansion; prevented by slow drainage and minimizing rapid negative pressure; monitor closely.
• D. Pulmonary edema due to fluid overload and treated with diuretics.

Answer: (C)

Re-expansion pulmonary edema is edema that develops in a lung after it is rapidly re-expanded following drainage of a collapsed lung or large pleural effusion. The sudden stretch and reperfusion of the previously compressed lung can cause capillary leakage and inflammatory swelling, leading to shortness of breath and low oxygen levels.

Prevention centers on controlled re-expansion. Draining slowly and avoiding aggressive suction minimizes the rapid negative pressures that can trigger edema. Techniques include limiting the rate of drainage, considering gradual re-expansion rather than rapid drainage (for example, avoiding full suction initially or using incremental drainage), and closely watching the patient for early signs of distress so drainage can be adjusted promptly. If edema does occur, provide supportive care with oxygen and, if needed, respiratory support.