Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty

A 69-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) was on amblatory oxygen inhalation therapy (3 L/min) and scheduled for percutaneous transluminal pulmonary angioplasty (PTPA). The patient's New York Heart Association functional status was class III with recent worsen...

Full description

Saved in:
Bibliographic Details
Main Authors: Kiyoshi Moriyama, Sayuri Sugiyama, Koji Uzawa, Mariko Kotani, Toru Satoh, Tomoko Yorozu
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2011/204538
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849683914081173504
author Kiyoshi Moriyama
Sayuri Sugiyama
Koji Uzawa
Mariko Kotani
Toru Satoh
Tomoko Yorozu
author_facet Kiyoshi Moriyama
Sayuri Sugiyama
Koji Uzawa
Mariko Kotani
Toru Satoh
Tomoko Yorozu
author_sort Kiyoshi Moriyama
collection DOAJ
description A 69-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) was on amblatory oxygen inhalation therapy (3 L/min) and scheduled for percutaneous transluminal pulmonary angioplasty (PTPA). The patient's New York Heart Association functional status was class III with recent worsening of dyspnea and apparent leg edema. Transthoracic echocardiography revealed right ventricular enlargement with mean pulmonary artery pressure of 42 mmHg. After PTPA, he was complicated with postoperative reperfusion pulmonary edema, and noninvasive positive pressure ventilation (NPPV) was applied immediately. Hypoxemia was successfully treated with 15 days of NPPV. Although mean pulmonary artery pressure was unchanged, his brain natriuretic peptide level decreased from preoperative 390.3 to postoperative 44.3 pg/dL. In addition, total pulmonary resistance decreased from preoperative 18 to postoperative 9.6 wood unit·m2. The patient was discharged on day 25 with SpO2 of 95% on 5 L/min of oxygen inhalation. Because pulmonary edema is a postsurgical life-threatening complication following PTPA, application of NPPV should be considered.
format Article
id doaj-art-d55b949b39e34e66be04db74ac19c381
institution DOAJ
issn 2090-6382
2090-6390
language English
publishDate 2011-01-01
publisher Wiley
record_format Article
series Case Reports in Anesthesiology
spelling doaj-art-d55b949b39e34e66be04db74ac19c3812025-08-20T03:23:38ZengWileyCase Reports in Anesthesiology2090-63822090-63902011-01-01201110.1155/2011/204538204538Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary AngioplastyKiyoshi Moriyama0Sayuri Sugiyama1Koji Uzawa2Mariko Kotani3Toru Satoh4Tomoko Yorozu5Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, JapanDepartment of Geriatric Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, JapanDepartment of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, JapanDepartment of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, JapanSecond Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, JapanDepartment of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, JapanA 69-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) was on amblatory oxygen inhalation therapy (3 L/min) and scheduled for percutaneous transluminal pulmonary angioplasty (PTPA). The patient's New York Heart Association functional status was class III with recent worsening of dyspnea and apparent leg edema. Transthoracic echocardiography revealed right ventricular enlargement with mean pulmonary artery pressure of 42 mmHg. After PTPA, he was complicated with postoperative reperfusion pulmonary edema, and noninvasive positive pressure ventilation (NPPV) was applied immediately. Hypoxemia was successfully treated with 15 days of NPPV. Although mean pulmonary artery pressure was unchanged, his brain natriuretic peptide level decreased from preoperative 390.3 to postoperative 44.3 pg/dL. In addition, total pulmonary resistance decreased from preoperative 18 to postoperative 9.6 wood unit·m2. The patient was discharged on day 25 with SpO2 of 95% on 5 L/min of oxygen inhalation. Because pulmonary edema is a postsurgical life-threatening complication following PTPA, application of NPPV should be considered.http://dx.doi.org/10.1155/2011/204538
spellingShingle Kiyoshi Moriyama
Sayuri Sugiyama
Koji Uzawa
Mariko Kotani
Toru Satoh
Tomoko Yorozu
Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty
Case Reports in Anesthesiology
title Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty
title_full Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty
title_fullStr Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty
title_full_unstemmed Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty
title_short Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty
title_sort noninvasive positive pressure ventilation against reperfusion pulmonary edema following percutaneous transluminal pulmonary angioplasty
url http://dx.doi.org/10.1155/2011/204538
work_keys_str_mv AT kiyoshimoriyama noninvasivepositivepressureventilationagainstreperfusionpulmonaryedemafollowingpercutaneoustransluminalpulmonaryangioplasty
AT sayurisugiyama noninvasivepositivepressureventilationagainstreperfusionpulmonaryedemafollowingpercutaneoustransluminalpulmonaryangioplasty
AT kojiuzawa noninvasivepositivepressureventilationagainstreperfusionpulmonaryedemafollowingpercutaneoustransluminalpulmonaryangioplasty
AT marikokotani noninvasivepositivepressureventilationagainstreperfusionpulmonaryedemafollowingpercutaneoustransluminalpulmonaryangioplasty
AT torusatoh noninvasivepositivepressureventilationagainstreperfusionpulmonaryedemafollowingpercutaneoustransluminalpulmonaryangioplasty
AT tomokoyorozu noninvasivepositivepressureventilationagainstreperfusionpulmonaryedemafollowingpercutaneoustransluminalpulmonaryangioplasty