title: Pulmonary alveolar proteinosis with respiratory failure-anaesthetic management of whole lung lavage.
abstract: Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by accumulation of amorphous acellular phospholipid material in the lungs. Whole lung lavage is the standard therapy which gives dramatic clinical improvement and offers a long term survival to these patients. A 43-year-old man suffering from PAP presented to casualty with NYHA grade IV dyspnoea with oxygen saturation (SaO(2)) on pulseoximetry 67% on room air and 78% with O(2) 6 L/min. He underwent whole lung lavage under general anaesthesia using one lung ventilation with 37 F left end bronchial double lumen tube. The lung lavage was initially performed for the left lung and for the right lung 4 days later. The patient was discharged home with oxygen saturation of 96 % on room air.
authors.affiliation: Senior consultant, P.D. Hinduja National hospital & Medical research centre, Veer savarkar marg, Mahim, MUMBAI-400016, INDIA.
authors.forename: Sunita
authors.initials: S
authors.lastname: Nandkumar
authors.forename: Madhavi
authors.initials: M
authors.lastname: Desai
authors.forename: Manju
authors.initials: M
authors.lastname: Butani
authors.forename: Z
authors.initials: Z
authors.lastname: Udwadia