scholarly journals Lobar flexible fiberoptic lung lavage: therapeutic benefit in severe respiratory failure in pulmonary alveolar proteinosis and influenza A H1N1 pneumonia

2011 ◽  
Vol 1 (3) ◽  
pp. 53 ◽  
Author(s):  
Antonello Nicolini ◽  
Cornelius Barlascini
Keyword(s):  
Respiratory Failure ◽  
Influenza A ◽  
Pulmonary Alveolar Proteinosis ◽  
Therapeutic Benefit ◽  
Lung Lavage ◽  
Safe Procedure ◽  
Severe Respiratory Failure ◽  
Influenza A H1n1 ◽  
Virus Pneumonia ◽  
Alveolar Proteinosis

Lobar fiberoptic lung lavage is a well-known procedure used in primary pulmonary alveolar proteinosis (PAP); the use of this procedure has increased in the recent years. This procedure has also been used in other pulmonary diseases such as desquamative interstitial pneumonia with good results. We describe a case of extremely severe respiratory failure due to concurrence of PAP and Influenza A H1N1 virus pneumonia which resolved with the help of this procedure. The patient, a 41- year-old woman, needed less mechanical ventilation after undergoing lobar fiberoptic bronchoscopic lavage. Moreover, a rapid and progressive improvement in the computed tomography of the lungs was observed. Flexibile fiberoptic bronchoscopic lobar lavage is a simple, safe procedure used not only in milder disease, but also in particular severe cases in which the physiological derangement of whole lung lavage would not be tolerated by patient or when extra-corporeal membrane oxygenation is not available.

scholarly journals Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain

Critical Care ◽  
2009 ◽  
Vol 13 (5) ◽  
pp. R148 ◽  
Author(s):  
Jordi Rello ◽  
Alejandro Rodríguez ◽  
Pedro Ibañez ◽  
Lorenzo Socias ◽  
Javier Cebrian ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Influenza A ◽  
Adult Patients ◽  
Severe Respiratory Failure ◽  
Influenza A H1n1

scholarly journals Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) severe respiratory failure in Japan

2012 ◽  
Vol 26 (5) ◽  
pp. 650-657 ◽  
Author(s):  
Shinhiro Takeda ◽  
◽  
Toru Kotani ◽  
Satoshi Nakagawa ◽  
Shingo Ichiba ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Influenza A ◽  
Severe Respiratory Failure ◽  
Membrane Oxygenation ◽  
Influenza A H1n1

scholarly journals Rare Presentation of Pulmonary Alveolar Proteinosis Causing Acute Respiratory Failure

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Ryan R. Kroll ◽  
Sameer Kumar ◽  
Ronald F. Grossman ◽  
Charles Price ◽  
John R. Srigley
Keyword(s):  
Respiratory Failure ◽  
Pulmonary Alveolar Proteinosis ◽  
Periodic Acid ◽  
Rare Condition ◽  
Lung Lavage ◽  
Hypoxemic Respiratory Failure ◽  
Rare Presentation ◽  
Periodic Acid Schiff ◽  
Novel Treatments ◽  
Alveolar Proteinosis

Pulmonary alveolar proteinosis (PAP) is a rare condition characterized by dysfunctional alveolar macrophages, which ineffectively clear surfactant and typically cause mild hypoxemia. Characteristic Computed Tomography findings are septal reticulations superimposed on ground-glass opacities in a crazy paving pattern, with a clear juxtaposition between affected and unaffected parenchyma. While traditionally PAP was diagnosed via biopsy, bronchoalveolar lavage (BAL) is usually sufficient; the fluid appears milky, and on microscopic examination there are foamy macrophages with eosinophilic granules and extracellular hyaline material that is Periodic Acid-Schiff positive. Standard therapy is whole lung lavage (WLL), although novel treatments are under development. The case presented is a 55-year-old woman with six months of progressive dyspnea, who developed hypoxemic respiratory failure requiring mechanical ventilation; she had typical findings of PAP on imaging and BAL. WLL was ultimately successful in restoring adequate oxygenation. Respiratory failure of this magnitude is a rare finding in PAP.

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