Extracorporeal membrane oxygenation to support whole-lung lavage in pulmonary alveolar proteinosis: salvage of the drowned lungs.

Abstract

Pulmonary alveolar proteinosis is a rare lung disease characterized by accumulation of lipoproteinaceous material within the alveoli. Therapeutic whole-lung lavage (WLL) under general anesthesia is the standard treatment in patients with progressive symptomatic disease. Severe hypoxemic respiratory failure is uncommon, yet when present poses a technical challenge to performing WLL without further compromising respiratory status. Rarely, hyperbaric chamber or extracorporeal membrane oxygenation (ECMO) has been utilized to perform WLL to manage severe hypoxemia, with venovenous ECMO being used more often. We present a case of hypoxemic and hypercarbic respiratory failure from pulmonary alveolar proteinosis successfully managed by placing the patient on venoarterial ECMO to facilitate the performance of bilateral WLL.

• Authors: Naveed Hasan, Sidharth Bagga, Julie Monteagudo, Hitoshi Hirose, Nicholas C Cavarocchi, Boyd T Hehn, Mani S Kavuru
• Journal: Journal of bronchology & interventional pulmonology (J Bronchology Interv Pulmonol) Vol. 20 Issue 1 Pg. 41-4 (Jan 2013) ISSN: 1948-8270 [Electronic] United States
• PMID: 23328142 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Behcet Syndrome (complications, therapy)
• Bronchoalveolar Lavage (methods)
• Extracorporeal Membrane Oxygenation (methods)
• Female
• Humans
• Hypercapnia (etiology, therapy)
• Hypoxia (etiology, therapy)
• Pulmonary Alveolar Proteinosis (complications, therapy)
• Respiratory Insufficiency (therapy)
• Treatment Outcome