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Heart, lung & circulation · Feb 2008
Case ReportsPulmonary alveolar proteinosis in extremis: the case for aggressive whole lung lavage with extracorporeal membrane oxygenation support.
- Alan D L Sihoe, Vivian M W Ng, Raymond W T Liu, and Lik-Cheung Cheng.
- Division of Cardiothoracic Surgery, The University of Hong Kong, Grantham Hospital, Hong Kong SAR, China.
- Heart Lung Circ. 2008 Feb 1; 17 (1): 69-72.
AbstractPulmonary alveolar proteinosis (PAP) is a rare disorder in which lipoproteinaceous material is deposited in the alveoli, compromising gaseous exchange. We report the case of a 29-year-old female patient presenting with the most extreme case of PAP yet reported. She successfully managed by aggressive bilateral whole lung lavage (WLL) in a single sitting using extracorporeal membrane oxygenation (ECMO) support. Despite critical hypercarbia and ventilator-dependence for 12 days before lavage, the patient experienced rapid recovery of pulmonary function after WLL and ECMO could be discontinued on-table. Aggressive WLL with ECMO support can be safe and effective even in the most severe cases of PAP.
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