Post-pneumonectomy pulmonary edema: is anesthesia to blame?

Post-pneumonectomy pulmonary edema is a major cause of early mortality following lung resection surgery. It is not clear whether this complication is caused by excessive perioperative intravenous fluid as was previously thought. The recent demonstration of increased pulmonary capillary permeability of the lung following a pneumonectomy suggests measures to try and decrease the incidence of this highly lethal syndrome. These measures include the judicious use of intravenous crystalloids, avoidance of lung hyperinflation and efforts to minimize the pulmonary artery pressure.