[Continuous intra-arterial blood gas monitoring during bronchopulmonary lavage for pulmonary alveolar proteinosis].

We report a clinical experience of continuous intra-arterial blood gas monitoring (PARATREND 7:P 7) during bronchopulmonary lavage. A 47-year-old, 86-kg male was suffering from myelodysplastic syndrome associated with alveolar proteinosis. Bronchopulmonary lavage was scheduled to alleviate the symptom. P 7 and a continuous cardiac output monitor were used with an EKG monitor, a pulse oximeter, and a esophageal stethoscope. Anesthesia was maintained using sevoflurane and fentanyl. The patient's trachea was intubated with a double-lumen endobronchial tube (39-F Broncho-cath; Mallinckrodt, Ireland). After denitrogenation and degassing, warmed isotonic saline was infused into his left lung. The volume chosen was 2,200 ml which approximated the sum of the patient's functional residual capacity and tidal volume. The lowest point of PO2 appeared at the point 'degassed'. P 7 showed a consecutive rise of PO2 associated with infusion of large volume of saline. Although the response to change in PO2 of P 7 is slower than pulse oximeter, frequent blood sampling can be avoided. We think that P 7 with pulse oximeter are useful for the safe management of pulmonary lung lavage.