Experience of use the veno-venous extracorporeal membrane oxygenation (VV-ECMO) during bronchoalveolar lavage in a patient with pulmonary alveolar proteinosis

Introduction . Alveolar proteinosis is a rare diffuse interstitial lung disease characterized by the accumulation of lipoproteins and phospholipids in the alveoli, which eventually leads to thickening of the alveolocapillary membrane, impaired oxygen diffusion, clinical manifestations and progression of respiratory failure, and, consequently, a decrease in the quality of life of patients. The disease was first described by S. H. Rosen et al. in 1958. The clinical picture is different, but the predominant complaint of the patient is shortness of breath and respiratory failure. Insufficient awareness of this disease among doctors leads to a later diagnosis and lack of quality care in accordance with the standards of the European Society for Respiratory Medicine. The objective was to demonstrate the clinical application of veno-venous extracorporeal membrane oxygenation (VV-ECMO) during total bronchoalveolar lavage in a patient with alveolar proteinosis. Results . The use of VV-ECMO in a patient with recurrent autoimmune pulmonary alveolar proteinosis with severe respiratory failure and total bilateral lung damage allowed for the safe performance of a total bronchoalveolar lavage procedure. The patient’s condition improved significantly, with an increase in arterial oxygen partial pressure from 38 to 72 mmHg, an increase in SpO₂ to 87% when breathing atmospheric air, and a significant improvement in exercise tolerance. Conclusion . The use of VV-ECMO allows for the safe performance of a total bronchoalveolar lavage procedure in a patient with total damage to both lungs due to pulmonary alveolar proteinosis.