title: Intraoperative use of a chest physiotherapy system during whole lung lavage for pulmonary alveolar proteinosis.
abstract: Pulmonary alveolar proteinosis (PAP) is a rare condition caused by the excessive alveolar accumulation of surfactant proteins. The current standard of care for removing these secretions is through therapeutic whole lung lavage (WLL). We describe two successful cases of bilateral WLL involving the novel use of the Vest™ chest physiotherapy system thereby avoiding the need for extensive changes in patient position in the intraoperative period. In brief, it involves the induction of general anesthesia followed by single-lung ventilation while simultaneously performing large volume lavages on the nonventilated lung. The washout was enhanced using the Vest™ system.
authors.affiliation: University of Iowa, Department of Anesthesia, 200 Hawkins Drive, 5JCP, Iowa City, IA 52242, USA. avinash-kumar@uiowa.edu
authors.forename: Avinash B
authors.initials: AB
authors.lastname: Kumar
authors.forename: Hans W
authors.initials: HW
authors.lastname: Schweiger
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D018893:Bronchoalveolar Lavage / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D061810:One-Lung Ventilation; D056888:Patient Positioning; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D011649:Pulmonary Alveolar Proteinosis / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome