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Pulmonary and Critical Care Pearls |

A 52-Year-Old Man With Pulmonary Edema Following Large-Volume Transfusion*

Linda L. Wolfenden; Henry E. Fessler
Author and Funding Information

*From the Division of Pulmonary, Allergy and Critical Care Medicine (Dr. Wolfenden), Department of Medicine, Emory University, Atlanta, GA; and Division of Pulmonary and Critical Care Medicine (Dr. Fessler), Department of Medicine, Johns Hopkins University, Baltimore, MD.

Correspondence to: Henry E. Fessler, MD, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 1830 E. Monument St, Fifth Floor, Baltimore, MD 21205; e-mail: hfessler@jhmi.edu



Chest. 2004;125(4):1556-1560. doi:10.1378/chest.125.4.1556
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Extract

A 52-year-old man with a history of mild hepatitis C cirrhosis presented with a chief complaint of several weeks of postprandial abdominal pain and anorexia. He had no history of coagulopathy, ascites, varices, or hepatic encephalopathy.

Evaluation revealed portal venous thromboses, and he underwent catheter-directed thrombolysis with tissue plasminogen activator (tPA). He was admitted to the medical ICU for routine postprocedure monitoring while receiving continuous tPA. On admission, he was alert and oriented, jaundiced, and the examination was otherwise unremarkable. The hemoglobin level prior to the procedure was 12.5 g/dL. Following the procedure, hemoglobin was stable on two serial measurements. Platelet count was 126,000/μL, and renal function, electrolytes, and international normalized ratio were normal.

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