Bronchopulmonary Lavage in Man

Ramirez-R, Jose; Kieffer, Richard F.; Ball, Wilmot C.

doi:10.7326/0003-4819-63-5-819

Cited by 157 publications

(50 citation statements)

References 10 publications

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“…The basic idea was to make the lung accessible to sonography by bronchoalveolar flooding. Liquid instillation into the lung has so far been used therapeutically in the form of bronchoalveolar lavage in alveolar proteinosis [4,12,13] and as liquid ventilation in treating the adult and infant respiratory distress syndrome [8,10,11]. Ventilation of one lung and simultaneous flooding of the other can only be managed with a double lumen tube.…”

Section: Discussionmentioning

confidence: 99%

Lung flooding — a new method for complete lung sonography

et al. 1998

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A sonographic examination of the lung has so far been impossible because of sound reflection. In conjunction with video-assisted thoracoscopic surgery, lung sonography would be helpful to make up for the lack of direct palpation. Animal experiments with pigs were performed to find out whether lung sonography becomes possible following bronchoalveolar flooding with a suitable liquid. The lung was filled with whole electrolyte solution through the left leg of a double-lumen endotracheal tube after resorption atelectasis (method 1) or compressive atelectasis (method 2). As an alternative, liquid perfluorocarbon was used (method 3). Under atelectasis, the lung thus flooded was investigated by ultrasound applied transpleurally and endobronchially. The first results proved that lung flooding is possible if certain prerequisites are fulfilled. Perfluorocarbon flooding led to total sound absorption which prevented sonography, whereas flooding with whole electrolyte solution made complete lung sonography possible, making visible the intrapulmonary vessels, bronchi and peribronchial lymphatic nodes. Measurements proved that the unilateral flooding caused no significant changes in the arterial and central venous pressure nor in transcutaneous oxygen saturation.

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Section: Discussionmentioning

confidence: 99%

Lung flooding — a new method for complete lung sonography

et al. 1998

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“…One-sided fluid flooding of the bronchial system after intubation with a double-lumen tube has been performed for 3 decades because of its application in the treatment of alveolar proteinosis [9], alveolar microlithiasis, acute pneumosilicosis, cystic fibrosis, and after inhalation of radioactive particles [4]. It has been shown that even extensive flushing with up to 40 l of a rinse solution is well tolerated [4].…”

Section: Discussionmentioning

confidence: 99%

Hemodynamics and gas exchange during experimental one-lung fluid flooding in pigs

Klinzing

Lesser

Schubert

et al. 1999

Research in Experimental Medicine

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One-sided fluid flooding of the lung after intubation with a double-lumen tube facilitates pulmonary sonography during surgery. Arterial blood pressure, cardiac index, and heart rate remained unchanged during one-lung fluid flooding in healthy animals. The arterial PO(2) was greater by about 100 mmHg after flooding one lung with 15 ml/kg fluid and ventilation with a FiO(2) of 1.0 compared with total atelectasis. This seems to be identical to a continuos positive airway pressure level of 5 cm H(2)O with pure oxygen on the nonventilated lung. The one-sided fluid flooding induced a statistically significant increase in pulmonary artery pressures and pulmonary capillary wedge pressure. In comparison with total atelectasis, fluid flooding in tendency reduced the pulmonary right-left shunt and increased the arterial PO(2).

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“…Proposed in the 1960s by Ramirez et al 5,6 Whole-Lung Lavage (WLL) is still the treatment of choice, providing an increase in PaO 2 , improved pulmonary function (FEV1, VC and diffusing capacity for carbon monoxide) and an increase in 5-year survival 3 .…”

Section: Introductionmentioning

confidence: 99%