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CARDIOVASCULAR ANESTHESIA

Chest Tube Suction-Associated Unilateral Negative Pressure Pulmonary Edema in a Lung Transplant Patient

Department of Anesthesiology, Perioperative and Pain Medicine, Division of Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

Address correspondence and reprint requests to Stavros G. Memtsoudis, MD, PhD, Department of Anesthesiology, Perioperative and Pain Medicine, Division of Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115. Address e-mail to smemtsoudis{at}partners.org.

We describe a 29-yr-old male, status post-bilateral lung transplant, who developed unilateral negative pressure pulmonary edema induced by chest tube suction in association with bilateral bronchial anastomotic strictures. We conclude that negative pressure pulmonary edema may occur secondary to high levels of negative pressure applied to the intrapleural space via chest tubes in the presence of partial large airway obstruction. Post-lung transplant patients may be especially at risk because of compromised lymphatic drainage.