Whole Lung Lavage under Hyperbaric Conditions: 2. Monitoring Tissue Oxygenation

Abstract

Pulmonary Alveolar Proteinosis (PAP) is characterized by dyspnea and progressive detoriation of arterial oxygenation, caused by accumulation of lipid- and protein-rich insoluble material in the alveoli. Bronchoalveolar lavage is the basic principle of treatment and can be performed while ventilating one lung. However due to severe pulmonary insufficiency, ventilation of one lung lessens arterial PO₂ to unacceptable levels. In order to prevent arterial and tissue hypoxemia we performed bronchoalveolar lavage under hyperbaric conditions as previously described¹. During these lavage procedures hemodynamic and central circulatory oxygen parameters were continuously monitored². Oxygenation of peripheral tissue was monitored by multiple assessments of skeletal muscle PO₂ (quadriceps musculature) with a polarographic pO₂ needle electrode³ and by transcutaneous pO₂ measurements. The aim of this study was to study alterations in muscle oxygenation during and after bronchoalveolar lavage.