Alveolar Proteinosis: Bronchoalveolar Lavage Experience and Current Literature Review

Abstract

Objective: Bronchoalveolar lavage (BAL) is considered as the first-line therapy for pulmonary alveolar proteinosis (PAP). The points to be kept in mind about the disease and its treatment were reviewed with current research and presented together with our clinical experience on the effectiveness of the BAL procedure. Methods: Patients with diagnosis of PAP were included. Total of 15 BALs were applied to 6 patients. Preoperative and 3rd postoperative hour arterial blood gas values were recorded. In addition to the partial oxygen pressures (PaO2), the ratio of the difference to the preoperative value was also evaluated and the lavage volumes of all patients were recorded. Results: A general significant increase in PaO2 was observed compared to pre-treatment. The correlation between the PaO2 change and the lavage volume per side was interpreted as a remarkable result even though statistical significance was not determined. Conclusion: An increase in PaO2 values post-lavage and a positive correlation between PaO2 change rate and lavage volume were observed. This may be a precursor to the idea that continuing lavage for a while after the lavage fluid has cleared improves the quality of the process. We believe that meta-analyses or studies with larger series are needed on this topic.