Stafford Marshall, Cappa Anthony, Weyant Michael, Lara Abigail, Ellis James, Weitzel Nathaen S, Puskas Ferenc
University of Colorado Denver, Aurora, CO 80045, USA.
Semin Cardiothorac Vasc Anesth. 2013 Jun;17(2):152-9. doi: 10.1177/1089253213486524. Epub 2013 Apr 30.
Acute silicoproteinosis is a rare disease that occurs following a heavy inhalational exposure to silica dusts. Clinically, it resembles pulmonary alveolar proteinosis (PAP); silica exposure is thought to be a cause of secondary PAP. We describe a patient with biopsy-confirmed acute silicoproteinosis whose course was complicated by acute hypoxemic respiratory failure requiring mechanical ventilation. Without clinical improvement despite antibiotic and steroid treatment, the patient was scheduled for whole-lung lavage under general anesthesia. Anesthetic challenges included double-lumen tube placement and single-lung ventilation in a hypoxic patient, facilitating lung lavage, and protecting the contralateral lung from catastrophic spillage.
急性硅蛋白沉着症是一种罕见疾病，发生于大量吸入二氧化硅粉尘之后。临床上，它类似于肺泡蛋白沉着症（PAP）；二氧化硅暴露被认为是继发性PAP的一个病因。我们描述了一名经活检确诊为急性硅蛋白沉着症的患者，其病程因急性低氧性呼吸衰竭而复杂化，需要机械通气。尽管接受了抗生素和类固醇治疗但临床症状无改善，该患者计划在全身麻醉下进行全肺灌洗。麻醉方面的挑战包括在一名低氧患者中放置双腔管和进行单肺通气、便于肺灌洗以及保护对侧肺免受灾难性溢出物的影响。
