Treatment of acute silicoproteinosis by whole-lung lavage

Semin Cardiothorac Vasc Anesth. 2013 Jun;17(2):152-9. doi: 10.1177/1089253213486524. Epub 2013 Apr 30.


Acute silicoproteinosis is a rare disease that occurs following a heavy inhalational exposure to silica dusts. Clinically, it resembles pulmonary alveolar proteinosis (PAP); silica exposure is thought to be a cause of secondary PAP. We describe a patient with biopsy-confirmed acute silicoproteinosis whose course was complicated by acute hypoxemic respiratory failure requiring mechanical ventilation. Without clinical improvement despite antibiotic and steroid treatment, the patient was scheduled for whole-lung lavage under general anesthesia. Anesthetic challenges included double-lumen tube placement and single-lung ventilation in a hypoxic patient, facilitating lung lavage, and protecting the contralateral lung from catastrophic spillage.

Keywords: critical care; noncardiac surgery; oxygen delivery; therapeutic impact; thoracic surgery.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Anesthesia, General / methods*
  • Biopsy
  • Bronchoalveolar Lavage / methods*
  • Humans
  • Hypoxia / etiology
  • Intubation, Intratracheal / methods
  • Lung
  • Male
  • One-Lung Ventilation / methods
  • Pulmonary Alveolar Proteinosis / diagnosis
  • Respiration, Artificial / methods
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy
  • Silicosis / diagnosis
  • Silicosis / physiopathology
  • Silicosis / therapy*