Postoperative respiratory failure due to acute eosinophilic pneumonia.

Abstract

A non-smoking 63-year-old man developed respiratory failure following surgical repair of a thoracoabdominal aortic aneurysm. He had severe hypoxemia and an elevated minute ventilation requiring prolonged mechanical support. Initial postoperative chest radiographs revealed new, transient, migratory infiltrates, and the patient received broad-spectrum antibiotic therapy. Chest radiographs subsequently demonstrated persistent, diffuse infiltrates, and bronchoalveolar lavage (BAL) analysis demonstrated significant eosinophilia (30%) with no evidence of infection. A diagnosis of acute eosinophilic pneumonia was made, and treatment with intravenous methylprednisolone resulted in rapid clinical improvement, and extubation. Acute eosinophilic pneumonia is not a previously recognized cause of postoperative respiratory failure and prolonged mechanical ventilation. It should be suspected in postoperative patients with unexplained diffuse lung infiltrates and acute respiratory failure.

• Authors: R C St John, J N Allen, E R Pacht
• Journal: Intensive care medicine (Intensive Care Med) Vol. 16 Issue 6 Pg. 408-10 ( 1990) ISSN: 0342-4642 [Print] United States
• PMID: 2246425 (Publication Type: Case Reports, Journal Article)

Chemical References

• Methylprednisolone

Topics

• Aorta, Abdominal
• Aorta, Thoracic
• Aortic Aneurysm (surgery)
• Diagnosis, Differential
• Humans
• Male
• Methylprednisolone (therapeutic use)
• Middle Aged
• Postoperative Complications (diagnostic imaging)
• Pulmonary Eosinophilia (complications, diagnostic imaging, drug therapy)
• Radiography
• Respiration, Artificial
• Respiratory Insufficiency (etiology, therapy)
• Ventilator Weaning