自己免疫性肺胞タンパク症に対する全肺洗浄法においてスマートベスト®を使用した1症例

The Beneficial Use of a SmartVest® in Whole-lung Lavage for a Patient with Autoimmune Pulmonary Alveolar Proteinosis

要旨

　自己免疫性肺胞タンパク症の77歳男性に対し，全肺洗浄法を施行した。洗浄時の理学療法として高頻度胸壁振動装置（スマートベスト^®）を使用した。処置中・処置後いずれも，著しい低酸素血症や皮膚障害など，大きな合併症は認めなかった。全肺洗浄法に，スマートベスト^®が有用である可能性が示唆された。

　Whole-lung lavage was scheduled on separate days for the left and right lungs of a 77-year-old Japanese man with autoimmune pulmonary alveolar proteinosis. For each lavage session, a high-frequency chest wall oscillation device（SmartVest^®, Electromed, New Prague, MN, USA）was attached over a skin foam dressing, and the patient wore the SmartVest over the dressing. After the lavage fluid was injected, the device was operated for 5 min at a frequency of 10 Hz as physical therapy. The whole-lung lavage was completed bilaterally without any problems with the tracheal tube’s position or significant hypoxia. There were also no skin lesions requiring intervention. These results suggest that the SmartVest^® may be useful for physiotherapy associated with whole-lung lavage.