Certified Registered Nurse Anesthetist at the University of Kansas Medical Center, Kansas City, Kansas. Email:
Clinical Assistant Professor, Department of Nurse Anesthesia Education, University of Kansas Medical Center, Kansas City, Kansas.
AANA J. 2024 Dec 1;92(6):453-458.
Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disorder characterized by the accumulation of surfactant/lipoprotein material in the alveoli and subsequent hypoxemic respiratory failure. Whole lung lavage (WLL), a procedure used to physically remove the lipoprotein material from the alveoli, is the first-line treatment for this disease process. Anesthesia providers may infrequently encounter the management of the WLL procedure due to the rarity of the underlying disease process. Pertinent anesthesia considerations for WLL are covered in the following case report. A review of the literature examines the pathophysiology of PAP, the various approaches to WLL, and the physiologic implications of WLL.
肺泡蛋白沉积症(PAP)是一种罕见的肺部疾病,其特征是表面活性剂/脂蛋白物质在肺泡中积聚,随后发生低氧性呼吸衰竭。全肺灌洗(WLL)是一种用于从肺泡中物理去除脂蛋白物质的程序,是该疾病过程的一线治疗方法。由于潜在疾病过程的罕见性,麻醉提供者可能很少遇到 WLL 程序的管理。以下病例报告涵盖了 WLL 的相关麻醉注意事项。对文献的回顾检查了 PAP 的病理生理学、WLL 的各种方法以及 WLL 的生理影响。