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Case Reports
. 2015 Nov 30:15:173.
doi: 10.1186/s12871-015-0152-3.

Extracorporeal membrane oxygenation to support repeated whole-lung lavage in a patient with pulmonary alveolar proteinosis in life threatening dyspnoe--a case report

Martina Krecmerova  1   2 , Frantisek Mosna  3   4 , Vladimír Bicek  5   6 , Frantisek Petrik  7 , Alzbeta Grandcourtova  8 , Marek Lekes  9 , Tomas Vymazal  10   11
Affiliations
Case Reports

Extracorporeal membrane oxygenation to support repeated whole-lung lavage in a patient with pulmonary alveolar proteinosis in life threatening dyspnoe--a case report

Martina Krecmerova et al. BMC Anesthesiol. .

Abstract

Backgroud: Pulmonary alveolar proteinosis is a rare disorder that is characterized by a large accumulation of lipoproteinaceous material within the alveoli. This causes respiratory failure due to a restriction of gas exchange and changes in the ventilation/perfusion ratio. Clinical symptoms are variable and depend on the severity of damage of the lung parenchyma. Treatment method is whole-lung lavage, where the accumulated lipoproteinaceous material is removed using large quantities of saline.

Case presentation: This case report describes a 45 year old patient with advanced pulmonary alveolar proteinosis. Due to the presence of severe global respiratory insufficiency, this patient could not undergo the classic whole-lung lavage using a double-lumen tube and selective lung ventilation. The whole-lung lavage was performed with the support of veno-venous extracorporeal membrane oxygenation. A total of 27 l of warm saline was used.

Conclusion: According to the current published literature, whole-lung lavage with extra-corporeal membrane oxygenation support is a very rare treatment method. Even when taking into account all of the risks associated with whole-lung lavage and v-v extracorporeal membrane oxygenation support, we found that this technique is very effective and, without a doubt, it saved the life of our patient.

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Figures

Fig. 1
Fig. 1
The character of the first (on the left) and the last portions of fluid used for the lung lavage
See this image and copyright information in PMC

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