The Annals of Thoracic Surgery, Vol 35, 313-317, Copyright © 1983 by The Society of Thoracic Surgeons
Bilateral simultaneous lung lavage utilizing membrane oxygenator for pulmonary alveolar proteinosis in an 8-month-old infant
LF Hiratzka, DM Swan, EF Rose and RC Ahrens
Pulmonary alveolar proteinosis can result in severe hypoxemia. Treatment of
symptomatic patients using unilateral or lobar staged lung lavage often
results in improved oxygenation and functional capacity. Lung lavage is
technically difficult in infants and small children because of inability to
ventilate part of the lung safely and adequately during lavage of other
areas. We used extracorporeal membrane oxygenation to facilitate adequate
gas exchange during lung lavage for severe respiratory failure in a 3.7 kg,
8-month-old child with pulmonary alveolar proteinosis. Oxygenation was
markedly improved immediately following the procedure. Extracorporeal
membrane oxygenation permits satisfactory respiratory support in the
setting of severe respiratory failure and should be considered an adjunct
for treatment of pulmonary alveolar proteinosis when lung lavage cannot be
otherwise safely accomplished.
