Tailoring Anesthesia for Whole Lung Lavage: Experiences from a Case Series

Aims and objectives: This article aims to describe the anesthetic management and perioperative challenges of performing sequential whole lung lavage (WLL) in patients with pulmonary alveolar proteinosis (PAP).Case description: We present a case series of seven patients in a relatively young age-group presenting with features suggestive of PAP confirmed by radiological findings and bronchoalveolar lavage (BAL) and successfully managed with therapeutic sequential WLL.Conclusion: Sequential WLL for PAP is a complex procedure that requires careful management to ensure patient safety and successful outcomes.Key aspects include maintaining effective lung isolation, using appropriate fluid management to prevent hypothermia and fluid overload, and vigilant monitoring of oxygenation and hemodynamics during the procedure.Postoperative care, including elective ventilation, is often required.The collaboration between the anesthetic, respiratory, and physiotherapy teams is crucial for optimal results.Clinical significance: WLL is a rare but effective treatment for PAP, though its anesthetic management is challenging.Successful implementation relies on meticulous lung isolation, careful monitoring of intraoperative hypoxia, hemodynamics, and postoperative ventilation.A coordinated approach between anesthetists, respiratory physicians, and physiotherapists is essential for improving patient outcomes and minimizing risks associated with the procedure.