Heart, Lung and Circulation
Volume 17, Issue 1, February 2008, Pages 69-72
Pulmonary Alveolar Proteinosis in Extremis: The Case for Aggressive
Whole Lung Lavage with Extracor****eal Membrane Oxygenation Sup****t
Alan D.L. Sihoe FRCSEd(CTh)a, , , Vivian M.W. Ng FANZCAb, Raymond W.T.
Liu FHKAMc and Lik-Cheung Cheng FRCSa
aDivision of Cardiothoracic Surgery, The University of Hong Kong,
Grantham Hospital, Hong Kong SAR, China
bDepartment of Anaesthesiology, The University of Hong Kong, Grantham
Hospital, Hong Kong SAR, China
cDepartment of Respiratory Medicine, Ruttonjee Hospital, Hong Kong
SAR, China
Pulmonary alveolar proteinosis (PAP) is a rare disorder in which
lipoproteinaceous material is deposited in the alveoli, compromising
gaseous exchange. We re****t the case of a 29-year-old female patient
presenting with the most extreme case of PAP yet re****ted. She
successfully managed by aggressive bilateral whole lung lavage (WLL)
in a single sitting using extracor****eal membrane oxygenation (ECMO)
sup****t. Despite critical hypercarbia and ventilator-dependence for 12
days before lavage, the patient experienced rapid recovery of
pulmonary function after WLL and ECMO could be discontinued on-table.
Aggressive WLL with ECMO sup****t can be safe and effective even in the
most severe cases of PAP.
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In medicine, "lavage" is a general term referring to cleaning or
rinsing.
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