{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:18:16Z","timestamp":1787840296826,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Pulmonary Alveolar Proteinosis (PAP) is a rare condition where surfactant accumulates in the lungs\u2019 alveoli, causing respiratory failure. Whole lung lavage (WLL) is the primary treatment, requiring careful perioperative management due to potential complications. We present the case of a 38-year-old man with severe PAP who underwent WLL with cardiopulmonary bypass standby. Preoperative assessment revealed severe hypoxemia and respiratory alkalosis. During surgery, he experienced desaturation and hemodynamic instability, necessitating noradrenaline support and real-time lung ultrasound monitoring. Postoperatively, significant improvements in oxygen levels and radiographic findings were observed. Diagnosis relies on Broncho alveolar lavage fluid analysis, and WLL is effective for patients with impaired gas exchange, improving symptoms and survival. This case highlights the importance of multidisciplinary care and meticulous perioperative management in achieving positive outcomes in PAP treatment with WLL.<\/jats:p>","DOI":"10.4103\/sja.sja_375_24","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T01:00:19Z","timestamp":1750035619000},"page":"400-402","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Breathing new life: Cutting-edge anesthetic strategies for whole lung lavage in pulmonary alveolar proteinosis"],"prefix":"10.4103","volume":"19","author":[{"given":"Anita","family":"Chouhan","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simran","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Kamal","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishant Kumar","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alok Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goverdhan Dutt","family":"Puri","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"R1-20260423","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1038\/s41572-019-0066-3","article-title":"Pulmonary alveolar proteinosis","volume":"5","author":"Trapnell","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20260423","doi-asserted-by":"crossref","first-page":"200018","DOI":"10.1183\/20734735.0018-2020","article-title":"Pulmonary alveolar proteinosis: From classification to therapy","volume":"16","author":"Salvaterra","year":"2020","journal-title":"Breathe (Sheff)"},{"key":"R3-20260423","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.21037\/jtd.2017.04.10","article-title":"Whole lung lavage-technical details, challenges and management of complications","volume":"9","author":"Awab","year":"2017","journal-title":"J Thorac Dis"},{"key":"R4-20260423","doi-asserted-by":"crossref","first-page":"701","DOI":"10.2147\/TCRM.S193884","article-title":"Update on diagnosis and treatment of adult pulmonary alveolar proteinosis","volume":"17","author":"Iftikhar","year":"2021","journal-title":"Ther Clin Risk Manag"},{"key":"R5-20260423","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.ccm.2016.04.006","article-title":"Pulmonary alveolar proteinosis syndrome","volume":"37","author":"Suzuki","year":"2016","journal-title":"Clin Chest Med"},{"key":"R6-20260423","doi-asserted-by":"crossref","first-page":"574","DOI":"10.3390\/tomography10040045","article-title":"Uncommon causes of interlobular septal thickening on CT images and their distinguishing features","volume":"10","author":"Donuru","year":"2024","journal-title":"Tomography"},{"key":"R7-20260423","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s13023-016-0497-9","article-title":"Whole lung lavage therapy for pulmonary alveolar proteinosis: A global survey of current practices and procedures","volume":"11","author":"Campo","year":"2016","journal-title":"Orphanet J Rare Dis"},{"key":"R8-20260423","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1159\/000455179","article-title":"Efficacy of whole-lung lavage in pulmonary alveolar proteinosis: A multicenter International study of GELF","volume":"93","author":"Gay","year":"2017","journal-title":"Respiration"},{"key":"R9-20260423","first-page":"91","article-title":"Experience with treatment of pulmonary alveolar proteinosis from a tertiary care centre in north India","volume":"54","author":"Khan","year":"2012","journal-title":"Indian J Chest Dis Allied Sci"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_375_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:19:45Z","timestamp":1787836785000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_375_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_375_24","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]},"assertion":[{"value":"2024-06-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}