Korean J Anesthesiol.  2017 Aug;70(4):462-466. 10.4097/kjae.2017.70.4.462.

Whole-lung lavage complicated with pneumothorax: a case report

• Ahn HJ
• Yang M
• Kim JA
• Heo B
• Kim JK
• Park SY

• KMID: 2386301
• DOI: http://doi.org/10.4097/kjae.2017.70.4.462

Abstract

A patient with pulmonary alveolar proteinosis underwent whole lung lavage of the right lung. Lavage of the left lung was not immediately possible because of severe hypoxemia. Three days later, after correction of hypoxemia, we re-attempted the left lung lavage. However, the patient had severe hypoxemia (SpOâ‚‚< 80%) within a few minutes of performing right one lung ventilation (OLV). On bronchoscopic examination, proper tube location was confirmed. Bronchodilator nebulization and steroid injection were attempted with no effect. While searching for the cause of the hypoxemia, we found that the breath sound from the right lung had become very weak and distant compared with that from initial auscultation. Right pneumothorax was diagnosed on chest X-ray and a chest tube was inserted. After confirming pneumothorax resolution, we re-tried right OLV and were able to proceed with the left lung lavage without signs of aggravating air leak, loss of tidal volume, or severe hypoxemia.

Keyword

Bronchoalveolar lavage; Pneumothorax; Pulmonary alveolar proteinosis

MeSH Terms

Anoxia
Auscultation
Bronchoalveolar Lavage
Chest Tubes
Humans
Lung
One-Lung Ventilation
Pneumothorax*
Pulmonary Alveolar Proteinosis
Therapeutic Irrigation*
Thorax
Tidal Volume