Yeungnam Univ J Med.  2020 Jan;37(1):67-72. 10.12701/yujm.2019.00360.

Whole lung lavage using a rapid infusion system to treat a patient with pulmonary alveolar proteinosis

• Ra SW
• Park SE
• Lee HK
• Han IS
• Park SH

• KMID: 2501411
• DOI: http://doi.org/10.12701/yujm.2019.00360

Abstract

Whole lung lavage (WLL) is a therapeutic procedure to remove accumulated material by infusing and draining the lungs with lavage fluid. This procedure has been regarded as the current standard of care to treat pulmonary alveolar proteinosis. However, the WLL protocol has not yet been standardized and the technique has been refined and modified a number of times. A rapid infusion system is a device used to infuse blood or other fluids at precise rates and normothermic conditions. This device is not typically used in WLL, which relies on the passive infusion of fluids using the gravitational force. However, in this study we performed WLL using a rapid infusion system, since we aimed to take advantage of its shorter operation time and greater degree of control over fluid volume and temperature. The patient’s symptoms improved without the occurrence of any complications.

Keyword

Infusion pump; Lung lavage; Pulmonary alveolar proteinosis

Figure

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  Fig. 1. Pre-whole lung lavage HRCT findings. HRCT scan shows ground glass opacities and crazy paving pattern. HRCT, high-resolution computed tomography.

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  Fig. 2. Transbronchial lung biopsy specimen from right lower lobe shows intraalveolar pinkish proteinaceous material (arrows), consistent with pulmonary alveolar proteinosis (hematoxylin and eosin stain, ×400).

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  Fig. 3. Left lateral decubitus position (lavage side up) and application of a Y-connector attached to the double lumen endotracheal tube.

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  Fig. 4. Intraoperative monitored vital sign denoted as ‘central venous pressure’ (arrow) shows pressure of injected fluid to the right lung.

Reference

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