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Post pneumonectomy

Robert F. Smith rfsmithmd at comcast.net
Wed Feb 13 10:50:49 GMT 2008


Back in the day weren't pneumonectomies occasionally done for other
pulmonary disease? Why were the outcomes better in more debilitated patients
with elective surgery?

Rob Smith

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of KMATTOX at aol.com
Sent: Monday, February 11, 2008 10:40 PM
To: trauma-list at trauma.org
Subject: Re: Post pneumonectomy pulmonary oedema

Karim:     I have seen this in far too many fit young  people.   It is far 
more common than anyone writes about.    Humans with acute cytokine release 
simply do not tolerate acute pneumonectomy  and CRASH between 12 and 18
hours.   
Perhaps should be maimntained on  membrane oxygenation and other supporting 
mechanisms for 3-5  days.         I would suggest you  consider a "lung
twist" to 
damage control the bleeding.   Take back to  OR at 8-12 hours and reassess, 
and then back 8-12 hours to reassess.    We need to talk about a good
protocol 
and a good experimental model.   
 
k
 
 
In a message dated 2/11/2008 9:33:47 P.M. Central Standard Time,  
karim at trauma.org writes:

Initially did well, extubated at 24 hours, comfortable, haemoserous
drainage
from chest tubes. 12 hours later after a couple of transient dips  in
saturation developed acute pulmonary oedema, froth coming up the ET  tube,
and died within minutes.  

Any  ideas?





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