Serviço de Anestesiologia, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
Serviço de Anestesiologia, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
Rev Esp Anestesiol Reanim (Engl Ed). 2023 Dec;70(10):602-607. doi: 10.1016/j.redare.2022.05.007. Epub 2023 Sep 3.
Whole lung lavage (WLL) is the first-line treatment for pulmonary alveolar proteinosis. We hypothesized that lung ultrasound (LUS) would guide flooding during treatment in a 15-year-old boy. WLL of each lung consisted of instillation of saline followed by kinesiotherapy and fluid drainage. In the first WLL, the lung was repeatedly flooded until the lavage fluid was clear on macroscopic examination. During this process, LUS was used to visualise lung aeration. In the second WLL, we used LUS signs to guide the lavage volume. The appearance of the fluid bronchogram sign showed that saline infusion could be stopped earlier than in the first lavage. In conclusion, LUS helped monitor the different stages of controlled lung de-aeration during WLL and reduce the total amount of saline used. This technique will also reduce the risk of WLL-related complications.
全肺灌洗（WLL）是治疗肺泡蛋白沉积症的一线治疗方法。我们假设，在一名 15 岁男孩的治疗过程中，肺部超声（LUS）可以指导灌洗。每侧肺的 WLL 包括盐水灌洗，随后进行运动治疗和液体引流。在第一次 WLL 中，反复灌洗肺部，直到宏观检查灌洗液变清澈。在此过程中，使用 LUS 观察肺部充气情况。在第二次 WLL 中，我们使用 LUS 征象来指导灌洗容量。液体支气管充气征的出现表明，与第一次灌洗相比，可以更早停止生理盐水输注。总之，LUS 有助于监测 WLL 过程中肺部控制性去充气的不同阶段，并减少使用的生理盐水总量。该技术还将降低与 WLL 相关的并发症的风险。
