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Power washing pulmonary alveolar proteinosis
Tiana R Endicott-Yazdani1, Gary S Schwartz2, Haiying Zhang3
1Department of Pulmonary and Critical Care Medicine, Baylor University Medical Center, Dallas, Texas.
Proceedings (Baylor University. Medical Center)
|November 4, 2021
Summary
Pulmonary alveolar proteinosis (PAP) treatment can be challenging due to severe hypoxemia. Whole-lung lavage using veno-venous extracorporeal membrane oxygenation (VV ECMO) offers a life-saving option for severe PAP cases.
Area of Science:
- Pulmonology
- Critical Care Medicine
Background:
- Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by surfactant accumulation in alveoli, leading to progressive dyspnea and hypoxemia.
- Severe PAP can be fatal if left untreated, with standard treatment being whole-lung lavage (WLL).
Observation:
- Patients with severe PAP often experience profound hypoxemia, precluding tolerance of single-lung ventilation required for conventional WLL.
- Previous case reports suggest the utility of VV ECMO for WLL in isolated instances.
Findings:
- This study successfully treated three patients with severe PAP using WLL supported by VV ECMO.
- VV ECMO provided essential oxygenation support, enabling the performance of WLL in critically ill patients.
Implications:
- VV ECMO-supported WLL represents a viable and potentially life-saving therapeutic strategy for severe pulmonary alveolar proteinosis.
- This approach may expand treatment options for patients with severe respiratory compromise due to PAP, improving outcomes.
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