title: Pulmonary lavage in a case of alveolar proteinosis. The value of continuous display oxygen--haemoglobin saturation using ear-oximetry.
abstract: A case of alveolar proteinosis is reported which was treated by lung lavage. The technique requires a Robertshaw double-lumen tube to isolate each lung. Initial ventilation with 100% oxygen removes lung nitrogen and the first 500 ml of saline occupies part of the functional reserve capacity and is not recovered. Lavage is then continued with 500-ml aliquots until the washings become clear. Monitoring the oxygen--haemoglobin saturation by ear-oximetry showed changes of between 15 and 20%, falling during suction and rising during infusion of lavage fluid. At the end of lavage, gas exchange is severely impaired by retained saline and a variable period of controlled ventilation may be required.
mesh_terms: D000328:Adult; D004423:Ear; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D008991:Monitoring, Physiologic; D010092:Oximetry; D011649:Pulmonary Alveolar Proteinosis / Q000628:therapy*; D012965:Sodium Chloride / Q000008:administration & dosage; D007507:Therapeutic Irrigation
chemical_list: D012965:Sodium Chloride