Q; Development of cough during thoracentesis indicates the sign of reexpansion pulmonary edema (REPE) and procedure should be stopped? (select one)
Indeed, the development of cough during thoracentesis indicates the reexpansion of lung but it has no correlation with reexpansion pulmonary edema (REPE).
Interestingly, a younger person between the age of 20 and 40 years is at a higher risk of REPE. Other risk factors include prolonged presence of pleural effusion, the application of high negative pressures during the procedure i.e.> - 20 cm H2O, and a large volumes thoracentesis i.e. > 1.5 L.
Procedure should only be stopped if cough becomes unbearable or patient shows signs of pulmonary edema such as shortness of breath or pink frothy sputum.
1. Feller-Kopman D, Berkowitz D, Boiselle P, et al. Large-volume thoracentesis and the risk of reexpansion pulmonary edema. Ann Thorac Surg 2007;84:1656–61
2. Sherman SC. Reexpansion pulmonary edema: a case report and review of the current literature. J Emerg Med 2003;24:23–7
3. Matsuura Y, Nomimura T, Murakami H, et al. Clinical analysis of reexpansion pulmonary edema. Chest 1991;100:1562–6
4. Feller-Kopman D, Parker MJ, Schwartzstein RM. Assessment of pleural pressure in the evaluation of pleural effusions. Chest 2009;135:201–9