Anesthetic management of bilateral pulmonary alveolar proteinosis for whole lung lavage

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare lung diseases in which there is abnormal accumulation of lung surfactant in alveoli by lipoproteinaceous material. The standard method for management of such cases is whole lung lavage (WLL). We report a PAP patient for WLL under general anesthesia and discuss the anesthetic challenges and management strategies to maintain adequate lung isolation and oxygenation, implementation of lateral positions of the patient with prolonged procedure and hypothermia during the lung lavage.

Keywords

• double lumen tube
• hypothermia
• one lung ventilation
• pulmonary alveolar proteinosis
• whole lung lavage