Pulmonary Alveolar Proteinosis with Respiratory Failure-Anaesthetic Management of Whole Lung Lavage

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by accumulation of amorphous acellular phospholipid material in the lungs. Whole lung lavage is the standard therapy which gives dramatic clinical improve-ment and offers a long term survival to these patients. A 43-year-old man suffering from PAP presented to casualty with NYHA grade IV dyspnoea with oxygen saturation (SaO 2 ) on pulseoximetry 67% on room air and 78% with O 2 6 L/min. He underwent whole lung lavage under general anaesthesia using one lung ventilation with 37 F left end bronchial double lumen tube. The lung lavage was initially performed for the left lung and for the right lung 4 days later. The patient was discharged home with oxygen saturation of 96 % on room air.

Keywords

• Pulmonary alveolar proteinosis
• Whole lung lavage
• Broncho-pulmonary lavage
• Anaesthesia