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Treatment of Acute Silicoproteinosis by Whole-Lung Lavage

2013; SAGE Publishing; Volume: 17; Issue: 2 Linguagem: Inglês

10.1177/1089253213486524

1940-5596

Marshall Stafford, Anthony Cappa, Michael J. Weyant, Abigail Lara, James V. Ellis, Nathaen Weitzel, Ferenc Puskás,

Neonatal Respiratory Health Research

Acute silicoproteinosis is a rare disease that occurs following a heavy inhalational exposure to silica dusts. Clinically, it resembles pulmonary alveolar proteinosis (PAP); silica exposure is thought to be a cause of secondary PAP. We describe a patient with biopsy-confirmed acute silicoproteinosis whose course was complicated by acute hypoxemic respiratory failure requiring mechanical ventilation. Without clinical improvement despite antibiotic and steroid treatment, the patient was scheduled for whole-lung lavage under general anesthesia. Anesthetic challenges included double-lumen tube placement and single-lung ventilation in a hypoxic patient, facilitating lung lavage, and protecting the contralateral lung from catastrophic spillage.