 improving only to 97% after an addition of 2 liters by nasal cannula.  A chest x-ray revealed bilateral pleural effusions and bibasilar atelectasis in addition to some pulmonary edema diffusely.  The patient's IV fluids were decreased.  He was given p.r.n. albuterol and infusion of Lasix, resulting in significant urine output.  His symptoms of shortness of breath gradually improved.  On August 1, 2008, he returned to the OR for final irrigation and debridement of his below-knee amputation.  Again, a wound VAC was placed.  Postoperatively, he did well.  His Foley catheter was removed.  His vital signs remained stable, and his respiratory status also remained stable.  Arrangements were made for home health and wound VAC care upon discharge.