Chauhan Sandeep, Sharma Kamal P, Bisoi Akshay K, Pangeni Raju, Madan Karan, Chauhan Yogendra S
Department of Cardiac Anesthesia, C.N.C, All India Institute of Medical Sciences, New Delhi, India.
Ann Card Anaesth. 2016 Apr-Jun;19(2):379-82. doi: 10.4103/0971-9784.179627.
Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by accumulation of excessive lung surfactant in the alveoli leading to restrictive lung functions and impaired gas exchange. Whole lung lavage (WLL) is the treatment modality of choice, which is usually performed using double lumen endobronchial tube insertion under general anesthesia and alternating unilateral lung ventilation and washing with normal saline. It may be difficult to perform WLL in patients with severe hypoxemia wherein patients do not tolerate single lung ventilation. Extracorporeal membrane oxygenation support (ECMO) has been used in such patients. We report a patient with autoimmune PAP following renal transplant who presented with marked hypoxemia and was managed by WLL under ECMO support.
肺泡蛋白沉积症（PAP）是一种罕见的肺部疾病，其特征是肺泡中积聚过多的肺表面活性物质，导致限制性肺功能和气体交换受损。全肺灌洗（WLL）是首选的治疗方式，通常在全身麻醉下插入双腔支气管导管，交替进行单侧肺通气并用生理盐水冲洗。对于严重低氧血症患者，可能难以进行WLL，因为这些患者无法耐受单肺通气。体外膜肺氧合支持（ECMO）已用于此类患者。我们报告了1例肾移植后发生自身免疫性PAP的患者，该患者出现明显低氧血症，并在ECMO支持下接受WLL治疗。
