Unique Hospital ICU

Post partum
Eclampsia young female

Develop AKI
and respiratory failure
Admitted in periphery and shifted to navasari . Shifted to surat for further management

On ventilator and hemodialysis started

2 d echo normal

The CT Chest was done s/o extensive alveolar consolidation

More than one month on ventilator and dialysis
Given two trial
Of steroid and broad spectrum antibiotics

Repeat ct scan and cxr at one month interval almost same and consolidation increased as compare to last CT

We did bronchoscopy
Sent PAS stain

Report : PAS positive material present
Alveolar macrophages with pas positive material seen

Compatible with
alveolar proteinosis

Pulmonary alveolar proteinosis (PAP) is a rare lung disorder of unknown etiology characterized by alveolar filling with floccular material that stains positive using the periodic acid-Schiff (PAS) method and is derived from surfactant phospholipids and protein components (see the image below). PAP was first described in 1958

The mainstay of PAP treatment for a very long time has been therapeutic whole-lung lavage (WLL). This procedure involves cleaning out one lung at a time with saline while the other lung is fed with oxygen. This procedure, performed under general anesthesia, usually takes from two to five hours.

ISurviveICU

45 years male came with fever, breathless and cough.

CXR was suggestive of bilateral lower lobe infiltration. Blood count was in favor of viral etiology.

he was too restless and needs NIV support to maintain saturation. Patient was intubated on next day due to worsening lung conditions.

patient was treated as per ARDS protocol. His H1N1 was negative.

He was ventilated for nine days and weaned on 10th day
as we all know now a days viral pneumonia with ARDs has not very good prognosis on ventilator. I thank my all ICU staff for managing this patient in a great manner and with responsibility.

Dr Khushbu Vaghasiya
Junior Intensivist
Unique Hospital