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증례보고 : 양측 경피적 신절석술 후 발생한 급성 폐부종
김지안 ( Jee Ahn Kim ),곽경화 ( Kyung Hwa Kwak ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.2
Percutaneous nephrolithotomy (PCNL) is currently the procedure of choice for the removal of large and complex renal calculi. With recent developments in percutaneous access technique and in equipment for the disintegration of calculi, simultaneous bilateral PCNL has become safe. However the complications include hemorrhage, extravasation and absorption of large volumes of irrigation fluid, fever, infection, colonic perforation and pneumothorax. A 46-year-old, 59 kg, female patient in our care developed acute pulmonary edema after simultaneous bilateral PCNL under general anesthesia. The preoperative chest X-ray was normal. The patient recovered following 36 hours of intensive treatment involving fluid restriction, diuretics, sedation and continuous airway pressure ventilation. (Korean J Anesthesiol 2007; 53: 270~3)