Rexpansion Pulmonary Edema

Ex vacuo pulmonary edema is a rare but potentially severe event with a mortality of 15-20%. We report the case of a patient who presented with ex vacuo pulmonary edema after drainage of a right pneumothorax. The pathophysiology of ex vacuo pulmonary edema is not yet clearly established, with mechanical and inflammatory factors (production of interleukin 8 and leukotriene B4) being the most incriminating. Certain factors, such as the duration and extent of pulmonary collapse and the speed of lung re-expansion after drainage, appear to favour the onset of ex vacuo edema, justifying certain precautionary measures. Curative treatment relies essentially on oxygenation and reduction of pleural aspiration pressures, but the best treatment is prevention.