Document Detail


Bronchioalveolar lavage with perfluorochemical liquid during conventional ventilation.
MedLine Citation:
PMID:  17693917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Therapeutic approaches with bronchioalveolar lavage are currently used in infants with severe alveolar space-occupying material. In many circumstances, bronchioalveolar lavage has been performed in conjunction with extracorporeal membrane oxygenation. CASE REPORT: A 2-month-old boy with severe respiratory failure requiring assisted ventilation did not respond to any conventional treatments, including surfactant. An open-lung biopsy showed intra-alveolar accumulation of proteinaceous material and foamy macrophages but was not diagnostically conclusive. Therapeutic trials with bronchioalveolar lavage using normal saline were unsuccessful, causing episodes of severe hypoxemia. Then, bronchioalveolar lavage during conventional mechanical ventilation was performed with the use of a medical-grade perfluorochemical liquid (perfluordecalin). After instillation of liquid (10 mL/kg), the lungs were refilled three times during the first 24 hrs and repeated 48 hrs later. During perfluorochemical liquid treatment, the infant's condition remained stable, with small improvements in pulmonary mechanics. Suction from the endotracheal cannula yielded only small amounts of gelatinous material. Considering the progression of the disease and just minimal pulmonary improvements by this intervention, further treatment was considered futile. Support was, thus, minimized, and the infant died a few days later. An autopsy revealed the diagnosis to be consistent with Niemann-Pick C2 disease. CONCLUSION: This study demonstrated that bronchioalveolar lavage with perfluorochemical liquid could be performed safely during conventional mechanical ventilation without the additional support of extracorporeal membrane oxygenation in infants with severe alveolar space-occupying material.
Authors:
Rolf Lindemann; Thomas Rajka; Thore Henrichsen; Ole Georg Vinorum; Charlotte de Lange; Aage Erichsen; Drude Fugelseth
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  8     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-10-24     Completed Date:  2008-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  486-8     Citation Subset:  IM    
Affiliation:
Paediatric Intensive Care Unit, Department of Paediatrics, Ulleval University Hospital, University of Oslo, Oslo, Norway. roli@uus.no
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MeSH Terms
Descriptor/Qualifier:
Bronchoalveolar Lavage / methods*
Combined Modality Therapy
Extracorporeal Membrane Oxygenation
Fatal Outcome
Fluorocarbons / therapeutic use*
Humans
Infant
Liquid Ventilation*
Male
Niemann-Pick Disease, Type C / complications
Respiration, Artificial
Respiratory Insufficiency / etiology,  therapy*
Chemical
Reg. No./Substance:
0/Fluorocarbons; 306-94-5/perfluorodecalin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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