Chouhan Anita, Kaur Simran, Kamal Manoj, Chauhan Nishant Kumar, Sharma Alok Kumar, Puri Goverdhan Dutt
Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Saudi J Anaesth. 2025 Jul-Sep;19(3):400-402. doi: 10.4103/sja.sja_375_24. Epub 2025 Jun 16.
Pulmonary Alveolar Proteinosis (PAP) is a rare condition where surfactant accumulates in the lungs' alveoli, causing respiratory failure. Whole lung lavage (WLL) is the primary treatment, requiring careful perioperative management due to potential complications. We present the case of a 38-year-old man with severe PAP who underwent WLL with cardiopulmonary bypass standby. Preoperative assessment revealed severe hypoxemia and respiratory alkalosis. During surgery, he experienced desaturation and hemodynamic instability, necessitating noradrenaline support and real-time lung ultrasound monitoring. Postoperatively, significant improvements in oxygen levels and radiographic findings were observed. Diagnosis relies on Broncho alveolar lavage fluid analysis, and WLL is effective for patients with impaired gas exchange, improving symptoms and survival. This case highlights the importance of multidisciplinary care and meticulous perioperative management in achieving positive outcomes in PAP treatment with WLL.
肺泡蛋白沉积症（PAP）是一种罕见疾病，其中表面活性剂在肺的肺泡中积聚，导致呼吸衰竭。全肺灌洗（WLL）是主要治疗方法，由于存在潜在并发症，需要进行仔细的围手术期管理。我们报告一例38岁患有严重PAP的男性患者，其在体外循环备用的情况下接受了WLL。术前评估显示严重低氧血症和呼吸性碱中毒。手术期间，他出现了氧饱和度下降和血流动力学不稳定，需要去甲肾上腺素支持和实时肺部超声监测。术后，观察到氧水平和影像学表现有显著改善。诊断依赖于支气管肺泡灌洗液分析，WLL对气体交换受损的患者有效，可改善症状并提高生存率。该病例突出了多学科护理和细致的围手术期管理在WLL治疗PAP取得良好结果中的重要性。
