Therapeutic Whole Lung Lavage for Alveolar Proteinosis

Nebulised sargramostim in pulmonary alveolar proteinosis

“…Pulmonary alveolar proteinosis has the potential to be a chronic and debilitating condition in those patients where spontaneous remission fails to occur. Currently, the mainstay of management in Australia has been for planned admission to intensive care for WLL 10–14 . In the absence of evidence for treatment superiority of WLL to GM‐CSF, patients and their health care providers may favour non‐invasive options as an initial treatment 24 .…”

“…Currently, the mainstay of management in Australia has been for planned admission to intensive care for WLL. [10][11][12][13][14] In the absence of evidence for treatment superiority of WLL to GM-CSF, patients and their health care providers may favour non-invasive options as an initial treatment. 24 Nebulised GM-CSF provides one of the first simple pharmacotherapeutic alternatives in the management of these patients.…”

“…Traditional treatment has been largely restricted to whole lung lavage (WLL) 10–14 . WLL was developed as a means of overcoming perfusion‐ventilation mismatch by physically removing or washing lipo‐proteinaceous material from the distal airways leading to symptomatic stability and remission for some.…”

“…Disease persistence and ongoing surfactant accumulation may therefore necessitate repeated treatments 15 . Whole lung lavage has been shown to provide symptomatic, radiographic and functional improvements 10–14 …”

Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report

“…It is now a standard technique for the early diagnosis of pulmonary edema in patients with heart failure, even in the subclinical stage [ 4 ]. There have been several reports on anesthesia management using LUS during WLL [ 5 , 6 ]. However, the use of LUS to monitor therapeutic procedures for both ventilated and non-ventilated lungs in the field of WLL is still in its infancy.…”