Anesthetic management of a case of pulmonary alveolar proteinosis for whole lung lavage

IF 0.2 Q4 RESPIRATORY SYSTEM
Manik Seth, Nishtha Kachru, Santvana Kohli, Ira Balakrishnan, Richa Chauhan, Virendra Kumar
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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.
肺泡蛋白沉积症全肺灌洗的麻醉处理
肺泡蛋白沉积症(PAP)是一种罕见的肺部疾病,其特征是肺泡内脂肪蛋白物质沉积。这导致肺顺应性降低和V/Q不匹配,导致呼吸衰竭。PAP患者可能会在麻醉下进行全肺灌洗(WLL),这对麻醉师来说是一个挑战。手术过程中需要双腔管辅助单肺通气,使原有的呼吸衰竭更加复杂。术中通气困难,需监测血气和气道压力。一定程度的低氧血症和高碳酸血症可能是必须容忍的。大量的液体被注入肺部,这可能导致低体温、高血容量和电解质紊乱。这些患者在术后经常需要选择性通气和重症监护。我们报告一例年轻女性与PAP,张贴单侧WLL麻醉下。我们希望强调这个病例可能带来的挑战,以及如何为这个病人进行安全的麻醉。
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来源期刊
自引率
0.00%
发文量
46
审稿时长
22 weeks
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.
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