Bilateral pulmonary edema after endoscopic sympathectomy in a patient with glucose-6-phosphate dehydrogenase deficiency
Authors: Lan, C.-J.; Luk, H.-N.; Wu, C.-T.; Chang, W.-K.; Tsou, M.-Y.; Lui, P.-W.; Lee, T.-Y.
Source: Acta Anaesthesiologica Scandinavica, Volume 45, Number 1, January 2001 , pp. 123-126(4)
Publisher: Blackwell Publishing
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Abstract:
Transaxillary endoscopic sympathectomy of thoracic ganglia (T2-T3) has recently gained wider acceptance as the treatment of choice for palmar hyperhidrosis. It requires one-lung ventilation to facilitate the surgery. One-lung ventilation, however, is not without complications, among which acute pulmonary edema has been reported. In this case report, we present a patient with palmar hyperhidrosis complicated by glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, who received bilateral endoscopic sympathectomy under alternate one-lung anesthesia, and developed acute pulmonary edema immediately after recruitment of the successive collapsed lung. The effects of hypoxemia, G-6-PD deficiency and sympathectomy might all add to the development of acute pulmonary edema secondary to reexpansion of each individual lung after alternate one-lung ventilation. The possibilities of the inferred causes are herein discussed.Keywords: Endoscopic sympathectomy; pulmonary edema; reexpansion; glucose-6-phosphate dehydrogenase deficiency; palmar hyperhidrosis
Document Type: Research article
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