گزارش يك مورد لاواژ برونكوپولمونري در بيمار مبتلا به پروتيينوز آلويولي

A CASE REPORT OF WHOLE LUNG LAVAGE IN A PATIENT WITH PULMONARY ALVEOLAR PROTEINOSIS

Alveolar proteinosis is a rare lung disease of unknown cause presenting with dyspnea and acinar pulmonary infiltrates due to lipoprotein - filled airspaces. A 34 aged man with cough and severe dyspnea was admitted with a diagnosis of pulmonary alveolar proteinosis. He underwent bronchopuirnonary lavage under general anesthesia. Before lavage he had obvious clinical and laboratory signs of respiratory failure including tachypnea, resting dyspnea, cyanosis, polycytemia (Hct=65%, Hb=18.3), hypoxia (Pao2=47mmg , Sao2=79%) and hypercarbia (Paco2=50mmHg). After preoperative assessment such as twice phlebotomy performed within 72 hours interval and preparation under general anesthesia first right lung and then after 4 days left lung was lavaged with 21 and 17 liters of normal saline solution respectively. After lavage of both lungs significant improvement in clinical and paraclinical signs was achieved. In arterial blood gas analysis Pao2 increased to 86 mmHg , Sao2 was 91% and Paco2 decreased to 38 mmHg. A significant resolution of airspace consolidation in chest X- Ray was observed.