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Author Topic: Pulmonary Edema After Laparoscopic Surgery  (Read 7221 times)

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yogenbhatt1

  • Yogen Bhatt, Mumbai, India
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Pulmonary Edema After Laparoscopic Surgery
« on: December 12, 2007, 10:23:11 PM »
      We have been hearing of Pulmonary Edema during or after a laparoscopic surgery, more so in Lap Hystrectomy.
     How often have other Anaesthesiologists faced it? Can you throw more light on pathophysiology of it and how to prevent and treat it?
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frontier

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Re: Pulmonary Edema After Laparoscopic Surgery
« Reply #1 on: December 16, 2007, 01:45:36 PM »
hi dr. yogen,
           difficult topic to be covered.in my opinion causes of pulmonary edema intraoperatively & postoperatively so many like 1.exterme trendelenberg position2.venous CO2 Embolism,fluid overload,preexisting cardiac,respiratory,hepatic & renal disease,adverse drug reaction,postobstructive pulmonary edema,absorption of irrigation fluid etc like in TURP & HYSTEROSCOPY HYSTERECTOMIES.
        non cardiogenic   pulmonary edema secondary to hyponatremic encephalopathy.sepsis,ARDS other thing to be ruled out. now fluid overload -increased hydrostaic pressure-LVF-pulmonary edema.CO2 venous embolism-pulmonary hypertension-pulmonary edema.now to prevent pulmonary edema treat etiologies.pulmonary artery catheterisation to assess fluid volume to be given.jugular venous cnnulation to aspirate emboli in case of venous embolism.while CO2 insuffulation one has to be slow & to see that all four quadrants equally rising.one has to be careful while giving fluid intraoperatively as anaesthetic drugs decrease afterload leading to more fluid administration,later on when the affect of drugs recede leading to pulmonary edema.preexising cardiac & lung diseases has to be dealt with carefully othewise more are the chances of pulmonary edema.oliguria & renal failure again a precipitating factor.now the treatment part treat etiologies +as usual treatment like IPPV,MECHANICAL VENTILATION,use of diuretcis & JUDICIOUS USE OF VASOPRESSORS & FLUID.last not the least is rule out sepsis,ARDS,hyponaremic encephalopathy etc.regards
« Last Edit: December 16, 2007, 02:28:08 PM by frontier »
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yogenbhatt1

  • Yogen Bhatt, Mumbai, India
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Re: Pulmonary Edema After Laparoscopic Surgery
« Reply #2 on: December 18, 2007, 12:40:26 PM »
Hi Frontier,
Thanks for the reply on the article of Pulm edema. But, kindly note that, I was looking for a different reply. It was only pertaining to laparoscopy. There are many reported cases of pulm edema following a lap surgery. I was interested in those causes, like a rise in pulm arterial pressure etc,
Thanks all the same.
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sandiphari

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Re: Pulmonary Edema After Laparoscopic Surgery
« Reply #3 on: October 16, 2008, 11:18:02 PM »
CO2 + HALOTHANE+RAISED  INTRA.ABD.PRESSURE MAY PPT. PUL.OEDEMA. IT IS ALMOST NILL IF U GIVE  RA+ GA COMBI.
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