Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942012000200013
Brazilian Journal of Anesthesiology
Clinical Information

Anestesia para lavagem pulmonar em paciente pediátrico portador de proteinose alveolar pulmonar

Downloads: 1
Views: 1238
JUSTIFICATIVA E OBJETIVOS: A proteinose alveolar pulmonar (PAP) é um transtorno raro, descrito inicialmente em 1958. A lavagem pulmonar total (LPT), proposta na década de 1960 ainda é o tratamento de escolha. Diversas técnicas foram descritas para realizar a lavagem pulmonar em pediatria, no entanto, todas apresentam limitações e riscos. RELATO DO CASO: Paciente de 6 anos e 8 meses, sexo feminino, 25 kg com o diagnóstico de proteinoise alveolar pulmonar submetida a lavagem pulmonar total por fibrobroncoscopia lobar sequencial sob anestesia geral em ventilação espontânea.
ANESTESIA, CIRURGIA, DOENÇAS RESPIRATÓRIAS, EQUIPAMENTOS, VENTILAÇÃO
BACKGROUND AND OBJECTIVES: Pulmonary Alveolar Proteinosis (PAP) is a rare disorder first described in 1958. The Whole-Lung Lavage (WLL) proposed in the 1960s, remains the treatment of choice. Several techniques have been described to perform lung lavage in pediatric patients; however, all have limitation and risks. CASE REPORT: Female patient, aged 6 years and 8 months, 25 kg, diagnosed with pulmonary alveolar proteinoisis, who underwent whole-lung lavage by sequential lobar fiberoptic bronchoscopy under general anesthesia and spontaneous ventilation.
Anesthesia, Bronchoscopy, Pediatrics, Pulmonary Alveolar Proteinosis, Ventilation

Rosen SH, Castleman B, Liebow AA. Pulmonary alveolar proteinosis. N Engl J Med. 1958;258:1123-1142.

Ben-Dov I, Kishinevski Y, Roznman J. Pulmonary alveolar proteinosis in Israel: ethnic clustering. Isr Med Assoc J. 1999;1:75-78.

Seymour JF, Presneill JJ. Pulmonary alveolar proteinosis: progress in the first 44 years. Am J Respir Crit Care Med. 2002;166:215-235.

Trapnell BC, Whitsett JA, Nakata K. Mechanisms of disease: pulmonary alveolar proteinosis. N Engl J Med. 2003;349:2527-2539.

Ramirez-Rivera J, Schultz RB, Dutton RE. Pulmonary alveolar proteinosis: a new technique and rationale for treatment. Arch Intern Med. 1963;112:419-431.

Ramirez-Rivera J, Kieffer RF Jr, Ball WC Jr. Bronchopulmonary lavage in man. Ann Intern Med. 1965;63(5):819-828.

Lippmann M, Mok MS, Wasserman K. Anaesthetic management for children with alveolar proteinosis using extracorporeal circulation: Report of two cases. Br J Anaesth. 1977;49:173-177.

Mahut B, de Blic J, Le Bourgeois M. Partial and massive lung lavages in an infant with severe pulmonary alveolar proteinosis. Pediatr Pulmonol,. 1992;13:50-53.

Moazam F, Schmidt JH, Chesrown SE. Total lung lavage for pulmonary alveolar proteinosis in an infant without the use of cardiopulmonary bypass. J Pediatr Surg. 1985;20:398-401.

Paschen C, Reiter K, Stanzel F. Therapeutic lung lavages in children and adults. Respir Res. 2005;6:138.

McKenzie B, Wood RE, Bailey A. Airway management for unilateral lung lavage in children. Anesthesiology. 1989;70:550-553.

Tsai WC, Lewis D, Nasr SZ. Liquid ventilation in an infant with pulmonary alveolar proteinosis. Pediatr Pulmonol. 1998;26:283-286.

Shah PL, Hansell D, Lawson PR. Pulmonary alveolar proteinosis: clinical aspects and current concepts on pathogenesis. Thorax. 2000;55(1):67-77.

Luisetti M, Pochetti P, Rodi G. Patients with pulmonary alveolar proteinosis enrolled in the San Matteo Hospital program for whole lung lavage: baseline characteristics and follow-up. Chest. 2001;120(4^sSuppl):270.

Kavuru MS, Popovich M. Therapeutic whole lung lavage: a stop-gap therapy for alveolar proteinosis. Chest. 2002;122(4):1123-1124.

Wang BM, Stern EJ, Schmidt RA. Diagnosing pulmonary alveolar proteinosis: A review and an update. Chest. 1997;111(2):460-466.

Morgan C. The benefits of whole lung lavage in pulmonary alveolar proteinosis. Eur Respir J. 2004;23(4):503-505.

Beccaria M, Luisetti M, Rodi G. Long-term durable benefit after whole lung lavage in pulmonary alveolar proteinosis. Eur Respir J. 2004;23:526-531.

Stocche RM, Garcia LV, Klamt JG. Anestesia para lavagem pulmonar em paciente portador de proteinose alveolar pulmonar: Relato de caso. Rev Bras Anestesiol. 2000;50(4):302-305.

Benumof JL. Anesthesia for Thoracic Surgery. 1995:553.

Hurrion EM, Pearson GA, Firmin RK. Childhood pulmonary alveolar proteinosis: Extracorporeal membrane oxygenation with total cardiopulmonary support during bronchopulmonary lavage. Chest. 1994;106:638-640.

Hodges O, Zar HJ, Mamathuba R. Bilateral partial lung lavage in an infant with pulmonary alveolar proteinosis. Br J Anaesth. 2010;104:228-230.

Paquet C, Karsli C. Technique of lung isolation for whole lung lavage in a child with pulmonary alveolar proteinosis. Anesthesiology. 2009;110:190-192.

Sivitanidis E, Tosson R, Wiebalck A. Combination of extracorporeal membrane oxygenation (ECMO) and pulmonary lavage in a patient with pulmonary alveolar proteinosis. Eur J Cardiothorac Surg. 1999;15:370-372.

5dd54c1f0e88259571c8fca7 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections