• Charles Her and Szabolcs Mandy.
• Department of Anesthesiology, New York Medical College, Valhalla, NY, USA. charles6133@msn.com
• J Clin Anesth. 2004 Jun 1; 16 (4): 244-50.

Study ObjectiveTo report that leukocyte-mediated acute injury may develop in a nonhypoxic lung after hypoxia-reoxygenation injury of the hypoxic lung and in other systemic organs in patients with reexpansion pulmonary edema.DesignCase report analysis with examination of the literature.SettingIntensive care unit of a university hospital.PatientsThree patients who developed leukocyte-mediated acute lung injury in the contralateral lung and systemic organ injury after ipsilateral reexpansion pulmonary edema of a collapsed lung.MeasurementsTo rule out the possibility that the acute lung injury in the contralateral lung was an extension of the hypoxia-reoxygenation injury, we analyzed changes in leukocyte and platelet count in the peripheral blood in relation to the development of pulmonary edema in each lung. Changes in liver enzymes were also analyzed to detect hepatic dysfunction as evidence of systemic organ injury.Main ResultsBoth leukocyte and platelet counts decreased when reexpansion pulmonary edema developed, and decreased further when acute lung injury developed in the contralateral lung (F = 8.42, p = 0.037 for leukocytes, and F = 17.66, p = 0.01 for platelets). Significant hepatic dysfunction developed, as evidenced by increases in both serum bilirubin (p = 0.001) and lactic dehydrogenase, indicating the presence of systemic organ injury.ConclusionsThe hypoxia-reoxygenation injury of one lung can induce acute lung injury in the other lung and systemic organ injury.

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