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Purpose of Review <p>Re-expansion pulmonary oedema is a rare complication of pleural intervention, but can be associated with high morbidity. We review the current literature to provide a clinical update on this poorly defined and difficult to manage condition, which continues to be associated with high mortality.</p> Recent Findings <p>Reactive oxygen species and pro-inflammatory cytokines are linked to increased protein permeability pulmonary oedema, as a consequence. Anti-inflammatory medications including glucocorticoids, misoprostil, ibuprofen and indomethacin have been associated with good outcomes. The use of pleural manometry has been postulated as a way to mitigate risk.</p> Summary <p>The multifactorial pathophysiology, together with heterogeneity in clinical symptoms, radiological presentation and inconsistency of supposed risk factors, highlights the complexity of REPO and the need for close clinical monitoring. The mainstay of treatment is supportive, alongside hypoxia correction when needed. The use of alternative treatments is emerging, but further evidence is required before these are implemented into guidance.</p>

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Re-expansion Pulmonary Oedema: Who, What, When and Why, A Review

  • 期刊论文

  • 发表日期：

    2025年7月31日

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  • Prasheena Naran,
  • Harry Bellenberg,
  • Clare Ross,
  • Anand Sundaralingam

摘要

Purpose of Review

Re-expansion pulmonary oedema is a rare complication of pleural intervention, but can be associated with high morbidity. We review the current literature to provide a clinical update on this poorly defined and difficult to manage condition, which continues to be associated with high mortality.

Recent Findings

Reactive oxygen species and pro-inflammatory cytokines are linked to increased protein permeability pulmonary oedema, as a consequence. Anti-inflammatory medications including glucocorticoids, misoprostil, ibuprofen and indomethacin have been associated with good outcomes. The use of pleural manometry has been postulated as a way to mitigate risk.

Summary

The multifactorial pathophysiology, together with heterogeneity in clinical symptoms, radiological presentation and inconsistency of supposed risk factors, highlights the complexity of REPO and the need for close clinical monitoring. The mainstay of treatment is supportive, alongside hypoxia correction when needed. The use of alternative treatments is emerging, but further evidence is required before these are implemented into guidance.