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Murray D. Altose, MD; Richard E. Hicks, MD; Mclver W. Edwards, Jr, MD

Arch Surg. 1976;111(10):1148-1153.

Abstract
• Extracorporeal membrane oxygenation (ECMO) in a venoarterial perfusion circuit was used to provide support of gas exchange during bronchopulmonary lavage in a 32-year-old man with pulmonary alveolar proteinosis and severe arterial hypoxemia. Prior to the lavage, Pao₂ during mechanical ventilation with 100% oxygen and positive end-expiratory pressure was only 125 mm Hg. Extracorporeal perfusion at a flow rate of 3 liters/min, with oxygen delivery of 244 ml/min, increased the Pao₂ to 227 mm Hg and lowered the mean pulmonary artery pressure from 28 to 24 mm Hg. During bronchopulmonary lavage and ECMO, the Pao₂ ranged between 46 and 96 mm Hg. After the procedure, pulmonary performance decidedly improved.

By reducing the chances of fatal hypoxemia, ECMO allowed treatment to be instituted for this potentially reversible disorder and proved helpful as a form of support during the management of pulmonary alveolar proteinosis when severe hypoxemia may have otherwise precluded bronchopulmonary lavage.

(Arch Surg 111:1148-1153, 1976)

Author Affiliations
From the departments of medicine, Cardiovascular-Pulmonary Division (Dr Altose), surgery (Dr Hicks), and anesthesiology (Dr Edwards), University of Pennsylvania School of Medicine, Philadelphia.

Footnotes
Accepted for publication June 3, 1976.

Reprint requests to 281 Gibson Building, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (Dr Altose).

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