Chest
Selected ReportsPulmonary Alveolar Proteinosis Causing Severe Hypoxemic Respiratory Failure Treated With Sequential Whole-Lung Lavage Utilizing Venovenous Extracorporeal Membrane Oxygenation: A Case Report and Review
Section snippets
Case Report
A 53-year-old woman presented to an outside hospital with progressive dyspnea, general malaise, and a decreased appetite over a duration of approximately 3 weeks. Chest radiography revealed bilateral alveolar infiltrates. ECG findings were remarkable for only sinus tachycardia. Abnormal laboratory findings at presentation included the following arterial blood gas measurements: pH, 7.5; Pco2, 30 mm Hg; Pao2, 30 mm Hg on room air; hemoglobin, 18.7 g/dL; and hematocrit, 55 %. An initial diagnosis
Discussion
In this report, we describe the most severely hypoxemic adult patient with respiratory failure secondary to pulmonary alveolar proteinosis ever reported in the literature. This also represents the first case in an adult where bilateral sequential WLL was performed under veno-venous ECMO with discontinuation of bypass prior to leaving the operating room.
The main physiologic disturbance in this disease is impairment of gas exchange secondary to filling of the alveoli with phospholipoproteinaceous
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