REPE

Q; Development of cough during thoracentesis indicates the sign of reexpansion pulmonary edema (REPE) and procedure should be stopped? (select one)

A) True
B) False


Answer: B

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.

#pulmonary
#procedures


References:

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