Topics in Pulmonary MedicineLife-threatening Re-expansion Pulmonary Edema: Is There a Role for Pleural Manometry During Therapeutic Thoracentesis?Siddiqi, Nasar A. MD*; Huggins, John T. MD*; Doelken, Peter MD†; Sahn, Steven A. MD*Author Information *Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, SC †Division of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY Disclosure: The authors declare that they have no conflicts of interest. Address correspondence to: Nasar A. Siddiqi, MD, 96 Jonathan Lucas Street, 812 CSB, MSC 630, Charleston SC 29425. E-mail: firstname.lastname@example.org. Clinical Pulmonary Medicine: January 2014 - Volume 21 - Issue 1 - p 46-49 doi: 10.1097/CPM.0000000000000010 Buy Metrics Abstract A 45-year-old woman with a high-grade Burkitt lymphoma developed reexpansion pulmonary edema (RPE) after drainage of 900 mL of pleural fluid. Sequential, bilateral therapeutic thoracenteses with pleural manometry were performed 2 weeks after the initial thoracentesis. Pleural manometry showed increased pleural space elastance in both pleural spaces; air-contrast computed tomography of the chest demonstrated visceral pleural thickening, involving both lungs, consistent with the diagnosis of bilateral, unexpandable lung due to the presence of visceral pleural restriction. The pathogenesis of RPE is unknown, but it is believed to involve a microvascular injury from reperfusion. The pathogenetic role of excessively negative pleural pressures in the development of RPE in humans has never been established. This is the first report utilizing pleural manometry to allow safe removal of pleural fluid in a patient who previously developed life-threatening RPE. © 2014 by Lippincott Williams & Wilkins, Inc.