An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis
As a rare procedure, massive bronchoalveolar lavage (MBAL) is a large-volume lavage which necessitates general anesthesia and one-lung ventilation (OLV). During MBAL isotonic saline is instilled into one lung and drained through one lumen of a double-lumen tube. MBAL is the most effective treatment...
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2012-09-01
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doaj-732c6f42631f4d1a83987b7ecbf9d6d02020-11-25T00:13:56ZengGalenos Publishing HouseBalkan Medical Journal2146-31232146-31312012-09-01293334338An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar ProteinosisBelgin SamurkaşoğluBehiye AkkalyoncuFatma UlusMehtap TunçÖzlem ÇakırPolat PehlivanoğluŞaziye ŞahinHilal Günal SazakAs a rare procedure, massive bronchoalveolar lavage (MBAL) is a large-volume lavage which necessitates general anesthesia and one-lung ventilation (OLV). During MBAL isotonic saline is instilled into one lung and drained through one lumen of a double-lumen tube. MBAL is the most effective treatment for symptomatic pulmonary alveolar proteinosis (PAP). A 27-year-old male with PAP was scheduled for therapeutic MBALs. After standard preoxygenation, monitoring and anesthesia induction, a double-lumen tube was placed. Tube position was verified by a fiberoptic bronchoscope. The internal jugular vein, radial and pulmonary arteries were cannulated. A temperature probe and foley catheter were inserted. The nonventilated lung was filled with 1000 mL saline and then drained in each session. The left and right lung were lavaged with an interval of 2 weeks. A total of 20 L saline was used in each MBAL without retention. MBALs were terminated after the effluent became clear. Duration of the left and right MBALs were 325 and 275 minutes, respectively. Despite increased shunt fraction, oxygenation was within acceptable limits during OLV. The trachea was extubated in the operating room uneventfully after each MBAL. The patient’s clinical and laboratory findings were evidently improved. Consequently, if proper conditions are provided, MBAL is safe and beneficial despite its risks and the long duration. http://www.balkanmedicaljournal.org/text.php3?id=895Bronchoalveolar lavagepulmonary alveolar proteinosisgeneral anesthesia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Belgin Samurkaşoğlu Behiye Akkalyoncu Fatma Ulus Mehtap Tunç Özlem Çakır Polat Pehlivanoğlu Şaziye Şahin Hilal Günal Sazak |
spellingShingle |
Belgin Samurkaşoğlu Behiye Akkalyoncu Fatma Ulus Mehtap Tunç Özlem Çakır Polat Pehlivanoğlu Şaziye Şahin Hilal Günal Sazak An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis Balkan Medical Journal Bronchoalveolar lavage pulmonary alveolar proteinosis general anesthesia |
author_facet |
Belgin Samurkaşoğlu Behiye Akkalyoncu Fatma Ulus Mehtap Tunç Özlem Çakır Polat Pehlivanoğlu Şaziye Şahin Hilal Günal Sazak |
author_sort |
Belgin Samurkaşoğlu |
title |
An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis |
title_short |
An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis |
title_full |
An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis |
title_fullStr |
An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis |
title_full_unstemmed |
An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis |
title_sort |
uncommon procedure for a rare ailment: massive bronchoalveolar lavage in a patient with pulmonary alveolar proteinosis |
publisher |
Galenos Publishing House |
series |
Balkan Medical Journal |
issn |
2146-3123 2146-3131 |
publishDate |
2012-09-01 |
description |
As a rare procedure, massive bronchoalveolar lavage (MBAL) is a large-volume lavage which necessitates general anesthesia and one-lung ventilation (OLV). During MBAL isotonic saline is instilled into one lung and drained through one lumen of a double-lumen tube. MBAL is the most effective treatment for symptomatic pulmonary alveolar proteinosis (PAP). A 27-year-old male with PAP was scheduled for therapeutic MBALs. After standard preoxygenation, monitoring and anesthesia induction, a double-lumen tube was placed. Tube position was verified by a fiberoptic bronchoscope. The internal jugular vein, radial and pulmonary arteries were cannulated. A temperature probe and foley catheter were inserted. The nonventilated lung was filled with 1000 mL saline and then drained in each session. The left and right lung were lavaged with an interval of 2 weeks. A total of 20 L saline was used in each MBAL without retention. MBALs were terminated after the effluent became clear. Duration of the left and right MBALs were 325 and 275 minutes, respectively. Despite increased shunt fraction, oxygenation was within acceptable limits during OLV. The trachea was extubated in the operating room uneventfully after each MBAL. The patient’s clinical and laboratory findings were evidently improved. Consequently, if proper conditions are provided, MBAL is safe and beneficial despite its risks and the long duration. |
topic |
Bronchoalveolar lavage pulmonary alveolar proteinosis general anesthesia |
url |
http://www.balkanmedicaljournal.org/text.php3?id=895 |
work_keys_str_mv |
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