Bilateral single sesion whole lung lavage under venous-venous ECMO in a case of severe pulmonary alveolar proteinosis: five years follow up

Introduction: Pulmonary alveolar proteinosis (PAP) is a rare disease caused by accumulation of proteinaceous material in the alveolar spaces. The most common mechanism implied is the development of antibodies directed to granulocyte macrophage colony stimulating factor (GM-CSF). which inhibits activ...

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Autores principales: Wainstein, Esteban Javier, Las Heras, Marcos, Sinner, Jorge, Kotowicz, Vadim, Precerutti, Juan, San Román, Juan, Svetliza, Graciela
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019
Materias:
extracorporeal membrane oxygenation
lung diseases
interstitial
respiratory insufficiency
oxigenación por membrana extracorporea
enfermedades pulmonares intersticiales
insuficiencia respiratoria
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/22595
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Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
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spelling I10-R327-article-225952024-08-27T18:24:07Z Bilateral single sesion whole lung lavage under venous-venous ECMO in a case of severe pulmonary alveolar proteinosis: five years follow up Lavado pulmonar total bilateral en una sola sesión bajo ECMO veno-venoso en un caso proteinosis alveolar severa: cinco años de seguimiento Wainstein, Esteban Javier Las Heras, Marcos Sinner, Jorge Kotowicz, Vadim Precerutti, Juan San Román, Juan Svetliza, Graciela extracorporeal membrane oxygenation lung diseases interstitial respiratory insufficiency oxigenación por membrana extracorporea enfermedades pulmonares intersticiales insuficiencia respiratoria Introduction: Pulmonary alveolar proteinosis (PAP) is a rare disease caused by accumulation of proteinaceous material in the alveolar spaces. The most common mechanism implied is the development of antibodies directed to granulocyte macrophage colony stimulating factor (GM-CSF). which inhibits activation of alveolar macrophage, thereby causing accumulation of surfactant. Standard treatment is considered to be whole lung lavage (WLL). Object: We present the case of a 47 years old woman referred for lung transplantation because of combined lung fibrosis and emphysema. Diagnose was change to respiratory failure secondary to PAP. We performed a single cession bilateral WLL under venous-venous ECMO. After  a 5 years follow up, the patients remains asymptomatic and with normal pulmonary physiology.Conclusions: The case highlights the importance of careful examination of previous diagnoses, in particular of cases referred for lung transplantation and provides factibility of performing single session bilateral WLL without causing right heart failure.  Introducción: la proteinosis alveolar es una enfermedad rara caracterizada por la acumulación de material proteináceo en los espacios alveolares. El principal mecanismo implicado es el desarrollo de anticuerpos contra el factor estimulante de colonias de granulocitos y macrófagos (GM-CSF), que impide la activación del macrófago alveolar y genera acumulación de surfactante.  Su tratamiento estándar es el lavado pulmonar total (LPT).Objetivo: presentar el caso de una mujer de 47 años derivada para trasplante pulmonar por sospecha de combinación de fibrosis y enfisema.  Se realizó el diagnóstico insuficiencia respiratoria por proteinosis alveolar pulmonar severa y se realizó tratamiento con lavado pulmonar total bilateral, secuencial y en una sola sesión bajo ECMO veno-venoso. A  5 años del tratamiento, la paciente se encuentra asintomática y con fisiología pulmonar normal. Conclusiones: el caso resalta la importancia de evaluar cuidadosamente el diagnóstico de todos los pacientes, en especial los que son derivados a trasplante pulmonar y muestra la factibilidad de realizar el lavado pulmonar total bajo ECMO veno-venoso sin producir claudicación del ventrículo derecho. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019-06-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Descripción application/pdf text/html image/png image/jpeg https://revistas.unc.edu.ar/index.php/med/article/view/22595 10.31053/1853.0605.v76.n2.22595 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 76 No. 2 (2019); 121-123 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 76 Núm. 2 (2019); 121-123 Revista da Faculdade de Ciências Médicas de Córdoba; v. 76 n. 2 (2019); 121-123 1853-0605 0014-6722 10.31053/1853.0605.v76.n2 spa https://revistas.unc.edu.ar/index.php/med/article/view/22595/23989 https://revistas.unc.edu.ar/index.php/med/article/view/22595/24127 https://revistas.unc.edu.ar/index.php/med/article/view/22595/27198 https://revistas.unc.edu.ar/index.php/med/article/view/22595/27315 Derechos de autor 2019 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic extracorporeal membrane oxygenation
lung diseases
interstitial
respiratory insufficiency
oxigenación por membrana extracorporea
enfermedades pulmonares intersticiales
insuficiencia respiratoria
spellingShingle extracorporeal membrane oxygenation
lung diseases
interstitial
respiratory insufficiency
oxigenación por membrana extracorporea
enfermedades pulmonares intersticiales
insuficiencia respiratoria
Wainstein, Esteban Javier
Las Heras, Marcos
Sinner, Jorge
Kotowicz, Vadim
Precerutti, Juan
San Román, Juan
Svetliza, Graciela
Bilateral single sesion whole lung lavage under venous-venous ECMO in a case of severe pulmonary alveolar proteinosis: five years follow up
topic_facet extracorporeal membrane oxygenation
lung diseases
interstitial
respiratory insufficiency
oxigenación por membrana extracorporea
enfermedades pulmonares intersticiales
insuficiencia respiratoria
author Wainstein, Esteban Javier
Las Heras, Marcos
Sinner, Jorge
Kotowicz, Vadim
Precerutti, Juan
San Román, Juan
Svetliza, Graciela
author_facet Wainstein, Esteban Javier
Las Heras, Marcos
Sinner, Jorge
Kotowicz, Vadim
Precerutti, Juan
San Román, Juan
Svetliza, Graciela
author_sort Wainstein, Esteban Javier
title Bilateral single sesion whole lung lavage under venous-venous ECMO in a case of severe pulmonary alveolar proteinosis: five years follow up
title_short Bilateral single sesion whole lung lavage under venous-venous ECMO in a case of severe pulmonary alveolar proteinosis: five years follow up
title_full Bilateral single sesion whole lung lavage under venous-venous ECMO in a case of severe pulmonary alveolar proteinosis: five years follow up
title_fullStr Bilateral single sesion whole lung lavage under venous-venous ECMO in a case of severe pulmonary alveolar proteinosis: five years follow up
title_full_unstemmed Bilateral single sesion whole lung lavage under venous-venous ECMO in a case of severe pulmonary alveolar proteinosis: five years follow up
title_sort bilateral single sesion whole lung lavage under venous-venous ecmo in a case of severe pulmonary alveolar proteinosis: five years follow up
description Introduction: Pulmonary alveolar proteinosis (PAP) is a rare disease caused by accumulation of proteinaceous material in the alveolar spaces. The most common mechanism implied is the development of antibodies directed to granulocyte macrophage colony stimulating factor (GM-CSF). which inhibits activation of alveolar macrophage, thereby causing accumulation of surfactant. Standard treatment is considered to be whole lung lavage (WLL). Object: We present the case of a 47 years old woman referred for lung transplantation because of combined lung fibrosis and emphysema. Diagnose was change to respiratory failure secondary to PAP. We performed a single cession bilateral WLL under venous-venous ECMO. After  a 5 years follow up, the patients remains asymptomatic and with normal pulmonary physiology.Conclusions: The case highlights the importance of careful examination of previous diagnoses, in particular of cases referred for lung transplantation and provides factibility of performing single session bilateral WLL without causing right heart failure. 
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2019
url https://revistas.unc.edu.ar/index.php/med/article/view/22595
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last_indexed 2024-09-03T21:00:24Z
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