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Abstract

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Article in Japanese

Case Report

Whole-lung lavage in pulmonary alveolar proteinosis supported by biphasic cuirass ventilation

Shinpei Kato  Norio Kasamatsu  Shuichi Matsuda  Shunsuke Sugimoto  Toshiaki Yano  Takashi Ogasawara 

Department of Respiratory Medicine, Hamamatsu Medical Center

ABSTRACT

A 64-year-old man showing an abnormal shadow on chest radiography was referred to our hospital. Chest CT scanning revealed a crazy-paving appearance, and bronchoalveolar lavage showed a milky appearance. High levels of autoantibodies against a granulocyte-macrophage colony-stimulating factor (GM-CSF) were confirmed, and he was diagnosed as autoimmune pulmonary alveolar proteinosis. During the following three-year observation, dyspnea on effort was gradually deteriorated, and whole-lung lavages were performed. We used biphasic cuirass ventilator (BCV) in the operation to improve washing efficiency of the lung. After he had injected washings in the lungs, we let the whole thorax vibrate by BCV and exhausted washings afterward. It was safe and simple to use BCV in the operation, and the recovery rate of drainage reached up to 100%. Abnormal chest shadow and oxygenation improved after bilateral whole-lung lavage. BCV may be useful in whole-lung lavage for the good recovery of cleaning fluid.

KEYWORDS

Pulmonary alveolar proteinosis  Whole-lung lavage  Biphasic cuirass ventilator 

Received 25 Apr 2014 / Accepted 18 Nov 2014

AJRS, 4(2): 185-188, 2015

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