[A patient with pulmonary alveolar proteinosis who underwent whole lung lavage under total intravenous anesthesia with propofol].
A 32-year-old male suffering from pulmonary alveolar proteinosis underwent whole lung lavage under one-lung ventilation and total intravenous anesthesia with propofol and fentanyl. The lung lavage was initially performed for the right lung, and for the left lung two weeks later. Spo2 and Pao2 declined at the time of lung degassing and drainage of lavage fluid (minimum values; Spo2 = 83%, Pao2 = 55.9 mmHg), and recovered on filling with the lavage fluid. Although pulmonary arterial pressure and central venous pressure were slightly increased at the time of unilateral lung filling, there was no marked change in arterial pressure, heart rate or cardiac output for lavage of either lung. % VC, DLCO and PaO2 markedly improved after whole lung lavage, from 26.0%, 5.84 ml.min 1.mmHg-1, and 61.9 mmHg in room air to 41.6%, 9.96 ml.min-1.mmHg-1, and 89.3 mmHg in room air, respectively. Since propofol does not inhibit hypoxic pulmonary vasoconstriction and is able to maintain a stable level of anesthesia, it is a useful anesthetic agent for whole lung lavage.
Tanaka
M
M
Department of Anesthesia, Osaka Railway Hospital of West Japan Railway Company.
Nakamura
C
C
Terai
T
T
Suzuki
N
N
D000328:Adult; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D018893:Bronchoalveolar Lavage; D006801:Humans; D008297:Male; D015742:Propofol; D011649:Pulmonary Alveolar Proteinosis / Q000628:therapy*; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D015742:Propofol