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Case Studies | Health Sciences | India | Volume 13 Issue 1, January 2024 | Popularity: 4.9 / 10

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A Comprehensive Case Report on the Anaesthetic Management of Whole Lung Lavage in Severe Autoimmune Pulmonary Alveolar Proteinosis

Dr. Jishnu Mohan, Dr. Israr-ul-haq, Dr. Afshan Pervaiz, Dr. Rukhsana Najeeb, Dr. Abjeet Kour

Abstract: This case report presents a comprehensive analysis of the anaesthetic management employed in the whole lung lavage (WLL) procedure for a 45 - year - old female diagnosed with severe autoimmune pulmonary alveolar proteinosis (PAP). Characterized by aberrant surfactant accumulation, PAP poses challenges to respiratory function, necessitating therapeutic interventions such as WLL. The anaesthetic strategy involved meticulous planning, lung isolation techniques, and the utilization of total intravenous anaesthesia (TIVA) to enhance procedural safety. Unique to this case was the strategic use of patient positioning during WLL, capitalizing on hypoxic pulmonary vasoconstriction (HPV) to optimize perfusion dynamics. Continuous monitoring, endobronchial suctioning, and judicious positive end - expiratory pressure (PEEP) application further ensured effective lung isolation. The post - procedural course, encompassing 16 - 18 hours of mechanical ventilation, a successful spontaneous breathing trial, and subsequent extubation, underscored the efficacy of the anaesthetic approach. This report contributes valuable insights into refining WLL techniques, emphasizing the integration of HPV and TIVA for optimal patient outcomes in severe autoimmune PAP cases.

Keywords: whole lung lavage WLL, pulmonary alveolar proteinosis PAP, anaesthetic management, hypoxic pulmonary vasoconstriction HPV, total intravenous anaesthesia TIVA

Edition: Volume 13 Issue 1, January 2024

Pages: 1773 - 1776

DOI: https://www.doi.org/10.21275/SR24126203928

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