Successful Treatment of Pulmonary Edema Caused by Transurethral Resection of the Prostate Syndrome

Abstract

Hung Tong Xuan, Trang Dinh Thi Thu, Dinh Ngo Van, Ly Nguyen Minh Department of Anesthesiology and Pain Medicine – 108 Military Central Hospital, Hanoi, VietnamCorrespondence: Ly Nguyen Minh No. 1 Tran Hung Dao Street, Hai Ba Trung District, Ha Noi City, 100000, VietnamTel [phone]Email [email protected]: Transurethral resection of the prostate (TURP) syndrome is a complication of transurethral resection of the prostate procedure. The incidence of TURP syndrome ranges from 0.78% to 1.4%. This syndrome is caused by excessive absorption of electrolyte-free and hypotonic washing solution. The fluids absorb into the circulation, which leads to heart failure, hyponatremia, and a decrease in serum osmolality. Cerebral edema, coma, pulmonary edema, cardiovascular collapse, and even death are common complications.Case Presentation: We report a patient who suffered severe TURP syndrome after transurethral resection of the prostate procedure. Clinical manifestations were pulmonary edema and respiratory failure. The concentration of Na+ was 112.6 mmol/l, which was severe hyponatremia. The serum osmolality pressure was 234mOsmol/kg, pH was 7.23, pO2 was 45mmHg and pCO2 was 44mmHg. The patient had successfully recovered after being used CPAP-PSV Pro breathing through a mask with + 5cmH2O of PEEP, 8cmH2O of supporting pressure, 70− 100% of FiO2, 20mg furosemide of intravenously, 150 mL of 3% NaCl, and 100mL natribicarbonate 8.4%.Conclusion: TURP syndrome is a life-threatening complication of transurethral resection of the prostate procedure, which is caused by excessive absorption of electrolyte-free and hypotonic washing solution. Therefore, the patient should be monitored seriously, diagnosed early, and treated promptly.Keywords: transurethral resection of the prostate syndrome, prostate tumours, pulmonary edema

Keywords

• transurethral resection of the prostate syndrome
• prostate tumours
• pulmonary edema