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Whole-lung lavage for pediatric patients with pulmonary alveolar proteinosis
Leigh Ann DiFusco1, Raj K Verma
1The Children's Hospital of Philadelphia, PA, USA.
Insights
Pulmonary alveolar proteinosis (PAP) is a rare pediatric lung disorder. Whole-lung lavage (WLL) is the primary treatment, requiring careful perioperative nursing to maintain patient stability and skin integrity during the procedure.
Area of Science:
- Pulmonology
- Pediatric Critical Care
- Perioperative Nursing
Background:
- Pulmonary alveolar proteinosis (PAP) is a rare chronic disorder affecting surfactant clearance in the lungs.
- Pediatric PAP is particularly uncommon, presenting unique management challenges.
- Whole-lung lavage (WLL) is the standard treatment for symptomatic PAP, aiming to improve gas exchange.
Observation:
- Perioperative nurses play a critical role in managing pediatric patients undergoing WLL.
- Key nursing responsibilities include maintaining patient vital signs, normothermia, and skin integrity.
- Nurses are often tasked with assembling the closed-drainage systems essential for WLL.
Findings:
- Effective perioperative management of pediatric PAP patients undergoing WLL requires meticulous attention to detail.
- Implementing patient-specific interventions is crucial for preventing complications.
- Successful WLL necessitates a well-prepared and collaborative nursing team.
Implications:
- Standardized procedural preference cards and targeted education enhance nursing preparedness for WLL.
- Multidisciplinary collaboration ensures a comprehensive and safe care plan for pediatric PAP patients.
- Optimizing perioperative nursing care can lead to improved outcomes for children with PAP.
Abstract:
Pulmonary alveolar proteinosis (PAP) is a chronic disorder of surfactant clearance from the alveoli. Its prevalence is rare, especially in the pediatric population. Although there is no cure for this condition, symptoms of PAP are managed most effectively through whole-lung lavage (WLL). Perioperative RNs caring for children with PAP undergoing WLL in the OR should implement patient interventions to maintain vital signs and normothermia and preserve skin integrity. Additionally, perioperative RNs often are responsible for assembling closed-drainage systems for WLL. Detailed procedural preference cards, targeted education sessions, and multidisciplinary collaboration are crucial for establishing a comprehensive plan of care for the pediatric patient with PAP undergoing WLL in the OR.
