Dextran syndrome, consisting of hypotension, pulmonary edema, anemia, and coagulopathy, was first described in 1975. While the incidence is low, there have been multiple subsequent reports linking dextran to this symptom complex. A 1997 review of dextran syndrome associated with hysteroscopic surgeries summarized 11 case reports or series. There have been other reports of ARDS occurring in patients receiving dextran as an anticoagulant following coronary artery stent deployment or after vascular microsurgery. Although hypotension characterized the initial report, the majority of patients in subsequent series have, like our patient, been normotensive. The pathophysiology of the dextran syndrome is postulated to include direct pulmonary toxicity, release of vasoactive mediators, activation of the coagulation cascade, intravascular intravasation of fluids, and hemodilution.