Lung lavage with hyperoxygenated fluid in patients with pulmonary alveolar proteinosis
- VernacularTitle:肺泡蛋白沉积症患者高氧液肺灌洗术的效果
- Author:
Hong-Mei WANG
;
Bin ZHOU
;
Pei-Hua XU
;
- Publication Type:Journal Article
- Keywords:
Oxygen;
Bronchoalveolar lavage;
Pulmonary alveolar proteinosis
- From:
Chinese Journal of Anesthesiology
1994;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Bilateral lung lavage was performed under general anesthesia with muscle relaxation in 3 patients with pulmonary alveolar proteinosis(PAP)aged 43-57 yrs weighing 48-68 kg.Left lung lavage was performed first and the right lung was lavaged one week later.Left radial artery and right internal jugular vein were cannulated for MAP,HR and CVP monitoring.SpO_2 and P_(ET) CO_2 were monitored during lavage.Left-sided Robertshaw double-lumen tube was used for both right and left lung lavage.After proper placement of the double- lumen tube was verified both lungs were ventilated with 100% O_2 for 10 min to wash out N_2.Hyperoxygenated lavage fluid was made by aerating the lactated Ringer's solution with 100% O_2 at 1 L?min~(-1) flow rate for 30 seconds.The tidal aliquot of lavage was 700 ml which was kept in the lung for 50 seconds and then drained.Each lung was lavaged with hyperoxygenated and plain lactated Ringer's solution 10 times each alternatively.While one lung was being lavaged the contralateral lung was mechanically ventilated with 100% O_2.SpO_2,MAP,HR,CVP and P_(ET)CO_2 were recorded immediately before lavage and at 10,20,30,40,50,60,70 and 80 seconds after the lung was filled with lavage fluid.SpO_2 was significantly higher during lavage with hyperoxygenated fluid than with ordinary lactated Ringer's solution,but there was no significant difference in MAP,HR,CVP and P_(ET)CO_2.The PaO_2 of the 3 patients breathing room air was 46-52 mm Hg before lung lavage and increased to(72.3?2.1) mm Hg one week after left lung lavage and to(83.5?4.8)mm Hg 3d after right lung lavage.During the lung lavage,hyperoxygenic significantly improve oxygen supply in patients with pulmonary alveolar proteinosis compared with lactated Ringer's solution.
