Acute and Critical Care

Case Reports

Anesthetic Management for Sequential Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis: A case report: You Seong Jeong, Hee Joo Kim, Jae Hwan Kim, Myoung Hoon Kong, Mi Kyeong Lee, Nan Suk Kim, Young Seok Choi, Sang Ho Lim; Korean J Crit Care Med. 1998;13(2):243-248.

Abstract PDF: Pulmonary alveolar proteinosis is a rare disease of unknown etiology characterized by the remittent or progressive accumulation of lipid-rich proteinaceous material within the alveolar space in the absence of inflammatory response. The removal of lipoproteinaceous material from the alveolar can the only means of effectively treating the progressive hypoxemia in pulmonary alveolar proteinosis. Bronchoalveolar lavage using a double-lumen endotracheal tube is an accepted modality for treatment of pulmonary alveolar proteinosis. We had utilized sequential bronchoalveolar lavage successfully for the treatment of a 51 year-old male patient with pulmonary alveolar proteinosis. There was no hypoxemia and unstable hemodynamics during the procedure. We conclude that the procedure will be safely performed by careful monitoring.

Atelectasis Due to Epistaxis Aspiration during Awake Fiberoptic Nasotracheal Intubation: Ju Tae Sohn, Sang Jung Lee, Kyung Il Hwang, Heon Keun Lee, Sang Hwy Lee, Young Kyun Chung; Korean J Crit Care Med. 1998;13(1):91-96.

Abstract PDF: Indication for fiberoptic intubation in an awake patient include almost any abnormality that may hinder the expeditious placement of an endotracheal tube during anesthetic induction. An epistaxis is the most frequent complication of nasotracheal intubation. The patient was admitted for open reduction and internal fixation due to severe mandible fracture. We experienced a case of atelectasis due to epistaxis aspiration during awake fiberoptic nasotracheal intubation in the conscious patient regionally anesthetized by both superior laryngeal nerve block and translaryngeal anesthesia, which is treated by saline irrigation, suction, active coughing and chest percussion.

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