Amount of liquid deficit in whole lung lavage predicts the need for mechanical ventilation
Pneumon, cilt.36, sa.2, 2023 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 2
- Basım Tarihi: 2023
- Doi Numarası: 10.18332/pne/161857
- Dergi Adı: Pneumon
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, Directory of Open Access Journals
- Anahtar Kelimeler: mechanical ventilation, whole lung lavage, pulmonary alveolar proteinosis, liquid deficit
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
INTRODUCTION Pulmonary alveolar proteinosis (PAP) is a rare syndrome that causes hypoxemic respiratory failure characterized by accumulation of lipoproteinous material in the alveoli. Whole lung lavage (WLL) is still the standard treatment which is based on the physical removal of the material with saline fluid. This study was aimed to evaluate the technical aspects of WLL procedures and postoperative complications in our unit. METHODS The study is a single-center retrospective study. A total of 83 WLLs performed on 21 PAP patients were evaluated. Saline was infused repetitively through the double-lumen intubation tube leading to the target lung in reverse Trendelenburg position and drained in the Trendelenburg position until the drained fluid became clear. Liquid deficits, complications and intensive care follow-up were recorded. RESULTS In all, 21 patients with a mean age of 38.2 ± 9.8 years underwent WLLs. The median number of procedures per patient was 2, the mean amount of fluid infused through the airways was 11.8 ± 4.3 L, while liquid deficit was 550 mL. Complications such as oxygen desaturation, arrhythmia, bronchospasm, epilepsy secondary to intracranial hemorrhage, pneumonia, and transient neuropathy were observed in 9 procedures; 59 (71.1%) procedures were followed by supplemental oxygen, 17 (20.5%) NIMV and 7 (8.4%) IMV support. The median residual liquid in the supplemental oxygen group was 485.19 ± 387 mL, 646.19 ± 652 mL in NIMV and 14009 ± 1419 mL (p<0.001) in the IMV (invasive mechanical ventilation) group. CONCLUSIONS WLL is a safe treatment method for PAP patients and foreseeing that the amount of residual liquid predicts the need for mechanical ventilator is beneficial in-patient management.