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Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report
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논문 기본 정보

Type
Academic journal
Author
Jae Wan Jung (Division of Pulmonary Medicine Department of Internal Medicine Wonkwang University Hospital Iksan K) Hyunho Lee (Department of Anesthesiology and Pain Medicine Ulsan University Hospital University of Ulsan Colleg) Oh Jimi (울산대학교)
Journal
영남대학교 의과대학 Journal of Yeungnam Medical Science Journal of Yeungnam Medical Science 제38권 제4호 KCI Accredited Journals
Published
2021.10
Pages
374 - 380 (7page)
DOI
10.12701/yujm.2021.01284

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Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report
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Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.
#Anesthesia #Extravascular lung water #One-lung ventilation #Pulmonary alveolar proteinosis #Ultrasonography

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References (20)

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Seung Won Ra / 2020 / Whole lung lavage using a rapid infusion system to treat a patient with pulmonary alveolar proteinosis / Yeungnam University Journal of Medicine 37(1):67~72 dbpia Via G / 2010 / Whole lung lavage : a unique model for ultrasound assessment of lung aeration changes / Intensive Care Med 36:999~1007 google schola Mata-Suarez SM / 2020 / Whole-Lung Lavage—a Narrative Review of Anesthetic Management / Journal of Cardiothoracic and Vascular Anesthesia Crossref Picano E / 2016 / Ultrasound of extravascular lung water : a new standard for pulmonary congestion / Eur Heart J 37:2097~2104 google schola Misra S / 2020 / Therapeutic whole lung lavage for alveolar proteinosis / J Cardiothorac Vasc Anesth 34:250~257 google schola

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