Q: Postpneumonectomy pulmonary edema is common after (select one) 

 A) right pneumonectomy 
B) left pneumonectomy


Answer: A

Postpneumonectomy pulmonary edema is more frequent after right pneumonectomy in comparison to left pneumonectomy. Actual cause is not known but various explanations have been put forward such as oxygen toxicity with high FiO2, or not adjusting proper tidal volume for one lung ventilation after surgery. Another explanation could be a reperfusion injury to the remaining lung. Preemptive use of a single intraoperative dose of 250 mg of Solu-Medrol, administered prior to ligation of the pulmonary artery is said to decrease the risk of postpneumonectomy pulmonary edema.


References:

1. Jordan S, Mitchell JA, Quinlan GJ, et al. The pathogenesis of lung injury following pulmonary resection. Eur Respir J 2000; 15:790.

2.Cerfolio RJ, Bryant AS, Thurber JS, et al. Intraoperative solumedrol helps prevent postpneumonectomy pulmonary edema. Ann Thorac Surg 2003; 76:1029.