Pulmonary Alveolar Proteinosis Causing Severe Hypoxemic Respiratory Failure Treated with Sequential Whole-lung Lavage Utilizing Venovenous Extracorporeal Membrane Oxygenation: a Case Report and Review

Pulmonary alveolar proteinosis is characterized by the accumulation of proteinaceous material in the alveoli leading to varying degrees of impairment in gas exchange. Generally, the degree of hypoxemia is mild, and it is rare to have respiratory failure requiring mechanical ventilation. We present a 53-year-old woman with the most severe degree of hypoxemia associated with alveolar proteinosis reported in the English-language adult literature. Her therapy of sequential whole-lung lavage performed while receiving venovenous extracorporeal membrane oxygenation in one operative session is the first reported successful use of this approach.