{"title":"Anesthetic management of a case of pulmonary alveolar proteinosis for whole lung lavage","authors":"Manik Seth, Nishtha Kachru, Santvana Kohli, Ira Balakrishnan, Richa Chauhan, Virendra Kumar","doi":"10.4103/ecdt.ecdt_48_23","DOIUrl":null,"url":null,"abstract":"Abstract Pulmonary Alveolar Proteinosis (PAP) is a rare disease of the lungs characterized by deposition of lipo-proteinaceous material in the alveoli. This leads to reduced lung compliance and V/Q mismatch, causing respiratory failure. Patients with PAP may be posted for Whole Lung Lavage (WLL) under anesthesia, which is a challenging case for anesthetists. Preexisting respiratory failure is complicated by requirement of single lung ventilation with the help of double lumen tube during the procedure. Intraoperative ventilation is difficult and is managed with blood gas and airway pressure monitoring. Some degree of hypoxemia and hypercapnia may have to be tolerated. Large volumes of fluid are instilled into the lung which may cause hypothermia, hypervolemia, and electrolyte disturbances. These patients frequently require elective ventilation and intensive care admission in the postoperative period. We report the case of a young woman with PAP, posted for unilateral WLL under anesthesia. We wish to highlight the possible challenges posed by this case and how to conduct a safe anesthesia for this patient.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Egyptian Journal of Chest Diseases and Tuberculosis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ecdt.ecdt_48_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Abstract Pulmonary Alveolar Proteinosis (PAP) is a rare disease of the lungs characterized by deposition of lipo-proteinaceous material in the alveoli. This leads to reduced lung compliance and V/Q mismatch, causing respiratory failure. Patients with PAP may be posted for Whole Lung Lavage (WLL) under anesthesia, which is a challenging case for anesthetists. Preexisting respiratory failure is complicated by requirement of single lung ventilation with the help of double lumen tube during the procedure. Intraoperative ventilation is difficult and is managed with blood gas and airway pressure monitoring. Some degree of hypoxemia and hypercapnia may have to be tolerated. Large volumes of fluid are instilled into the lung which may cause hypothermia, hypervolemia, and electrolyte disturbances. These patients frequently require elective ventilation and intensive care admission in the postoperative period. We report the case of a young woman with PAP, posted for unilateral WLL under anesthesia. We wish to highlight the possible challenges posed by this case and how to conduct a safe anesthesia for this patient.
期刊介绍:
The journal will cover technical and clinical studies related to health, ethical and social issues in field of The Egyptian Journal of Chest Diseases and Tuberculosis aims to publish and inform readers and all chest physicians of the progress in medical research concerning all aspect of chest diseases. Publications include original articles review articles, editorials, case studies and reports which are relevant to chest diseases. The Journal also aims to highlight recent updates in chest medicine. . Articles with clinical interest and implications will be given preference.