Systemic capillary leak syndrome under general anesthesia: a case report.

[systemic capillary leak syndrome]

Systemic capillary leak syndrome (SCLS ) is very rare and lethal disease and only 150 cases have been reported after the first publication of its report in 1960 by Clarkson . SCLS is characterized by hemoconcentation and hypoalbuminemia caused by reversible plasma extravasation . Its mechanism is unknown , but transient dysfunction of the endothelium is the most suspected cause and trigger of this event may cause immunologic disarrangement . After recovery of endothelial function , fluid injected during the shock period is redistributed and can cause severe pulmonary edema . SCLS should be considered in patients with acute and severe hypotension with hemoconcentration and hypoalbuminemia without obvious cardiac dysfunction . Especially we should take into account the possibility of SCLS if fluid replacement does not work or the shock state is aggravated despite aggressive fluid resuscitation and vasopressor administration . SCLS itself is a very rare disease ; furthermore , SCLS that develops during well-controlled surgery is even more rare . So we report this case with review of the literature .