title: Treatment of acute silicoproteinosis by whole-lung lavage.
abstract: Acute silicoproteinosis is a rare disease that occurs following a heavy inhalational exposure to silica dusts. Clinically, it resembles pulmonary alveolar proteinosis (PAP); silica exposure is thought to be a cause of secondary PAP. We describe a patient with biopsy-confirmed acute silicoproteinosis whose course was complicated by acute hypoxemic respiratory failure requiring mechanical ventilation. Without clinical improvement despite antibiotic and steroid treatment, the patient was scheduled for whole-lung lavage under general anesthesia. Anesthetic challenges included double-lumen tube placement and single-lung ventilation in a hypoxic patient, facilitating lung lavage, and protecting the contralateral lung from catastrophic spillage.
authors: University of Colorado Denver, Aurora, CO 80045, USA. marshall.stafford@ucdenver.edu
authors: Marshall
authors: M
authors: Stafford
authors: Anthony
authors: A
authors: Cappa
authors: Michael
authors: M
authors: Weyant
authors: Abigail
authors: A
authors: Lara
authors: James
authors: J
authors: Ellis
authors: Nathaen S
authors: NS
authors: Weitzel
authors: Ferenc
authors: F
authors: Puskas
mesh_terms: D000208:Acute Disease; D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D001706:Biopsy; D018893:Bronchoalveolar Lavage / Q000379:methods*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007442:Intubation, Intratracheal / Q000379:methods; D008168:Lung; D008297:Male; D061810:One-Lung Ventilation / Q000379:methods; D011649:Pulmonary Alveolar Proteinosis / Q000175:diagnosis; D012121:Respiration, Artificial / Q000379:methods; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D012829:Silicosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*
keywords: critical care; noncardiac surgery; oxygen delivery; therapeutic impact; thoracic surgery