Tension chylothorax in the late postoperative period of left-sided pneumonectomy

Coco, L.F.; Redondo Enríquez, J.M.; Pardo Romero, G.; Barba Orejudo, A.

doi:10.1016/j.redare.2019.07.011

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"apellidos" => "Barba Orejudo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital San Pedro de Alcántara, Complejo Hospitalario Universitario de Cáceres, Cáceres, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Quilotórax a tensión en postoperatorio tardío de neumonectomía izquierda" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 710 "Ancho" => 900 "Tamanyo" => 40122 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Posteroanterior chest radiograph performed with a portable device, showing a completely opaque left hemithorax with displacement of mediastinal structures and heart to the right. *Left tension chylothorax." ] ] ] "textoCompleto" => "A 52-year-old woman, weight 66 kg, height 157 cm, ASA physical status II, former smoker, underwent left pneumonectomy for adenocarcinoma in the lower left lobe.Following surgery, which was uneventful, the patient was transferred to the ICU, and from there to the hospital ward.Fory-eight hours later, she presented severe hypotension refractory to fluid therapy and vasopressors, followed by respiratory failure. She was transferred to the ICU. On admission, she had sinus tachycardia at 120–130 bpm, marked peripheral cyanosis and severe arterial hypotension (mean blood pressure <55 mmHg). Etomidate and succinylcholine were administered, the patient was intubated, and intravenous infusion of norepinephrine was started. An urgent chest radiograph (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) showed complete occupation of the left hemithorax with mediastinal displacement. Thoracentesis was performed (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A) and a drainage catheter was inserted (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B), which yielded a cloudy liquid. The study and analysis of the sample confirmed the suspicion of chylothorax (leukocytes 1922 leu/μl, prodominantly polymorphonuclear, triglycerides 825 mg/dl and cholesterol 83 mg/dl). The patient made good progress.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Coco LB, Redondo Enríquez JM, Pardo Romero G, Barba Orejudo A. Quilotórax a tensión en postoperatorio tardío de neumonectomía izquierda. Rev Esp Anestesiol Reanim. 2020;67:49–50." ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 710 "Ancho" => 900 "Tamanyo" => 40122 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Posteroanterior chest radiograph performed with a portable device, showing a completely opaque left hemithorax with displacement of mediastinal structures and heart to the right. *Left tension chylothorax." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 868 "Ancho" => 1250 "Tamanyo" => 130244 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "A) Image of the drain showing the creamy, yellowish appearance of the collection. 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ISSN: 2341-1929

Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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Vol. 67. Issue 1.