LAUSR

A 29-year-old gentleman, with no significant past medical illness, presented with a history of fall into a tank of AlumolTM 145 (a lubricant oil) at his workplace. He remained in the tank for a few minutes and had aspirated the oil. He was shifted to our centre intubated from another centre. Worsening disorientation and hypoxia had warranted intubation. In the intensive care unit( ICU), he continued to have refractory hypoxia requiring a fraction of inspired oxygen (FiO2) of 1.0 and positive end expiratory pressure of 10 cm H2O to maintain oxygen saturation (SpO2) at 90%. Arterial blood gas showed pH: 7.402, pO2: 62 mmHg, pCO2: 41.9 mmHg and Lactate 1.1 mmol/L. High Resolution Computed tomography of chest findings were consistent with a radiological diagnosis of ELP [Figure 1]. An emergent bronchoalveolar lavage and its examination were consistent with ELP; oil-laden macrophages, staining positive for oil red O stain. With few options and hardly any precedents, WLL was planned given the refractory hypoxia.