Whole lung lavage
Other namesLung washing
ICD-9-CM33.99

Whole lung lavage (WLL), also called lung washing, is a medical procedure in which the patient's lungs are washed with saline (salt water) by filling and draining repeatedly. It is used to treat pulmonary alveolar proteinosis, in which excess lung surfactant proteins prevent the patient from breathing.[1][2] Some sources consider it a variation of bronchoalveolar lavage.[3]

WLL has been experimentally used for silicosis,[4] other forms of mineral inhalation, and accidental inhalation of radioactive dust.[5] It appears to effectively remove these foreign particles.[4][6] WLL treatments may slow down the lung function decline of miners with pneumoconiosis.[7]

Medical uses

Procedure and technique

WLL is not a standarized procedure. Patients are usually first put under general anesthesia. A double lumen endotracheal tube is used to keep one lung breathing while the other is being washed. The lung to be washed is filled with fluid by gravity, then drained. Drainage can be done by suction[2] or gravity.[8] Some versions add a shaking step between the filling and draining to help with the washing.[2] The procedure typically uses 10–20 liters of fluid per patient, but severe cases require up to 50.[2]

Variations on the WLL include a "mini-WLL" with reduced infusion volume.[9] Reducing the suction power seems to reduce lung injury.[10]

Solutions

Devices

Adverse effects

Mechanism of action

History

See also

References

  1. ↑ Michaud, G.; Reddy, C.; Ernst, A. (2009). "Whole-lung lavage for pulmonary alveolar proteinosis". Chest. 136 (6): 1678–1681. doi:10.1378/chest.09-2295. PMID 19995769.
  2. 1 2 3 4 Cleveland Clinic (6 August 2014). "How 'Lung Washing' Helps You Breathe Again". HealthEssentials. Archived from the original on 14 August 2020. Retrieved 25 March 2020.
  3. ↑ Patel, Pujan H.; Antoine, Marsha H.; Ullah, Saad (2023). "Bronchoalveolar Lavage". StatPearls. StatPearls Publishing. PMID 28613513.
  4. 1 2 Prudon, B; Attanoos, R; Morgan, C; Stenton, Sc (December 2012). "P112 Therapeutic Whole Lung Lavage For Silicosis – First Application in the UK". Thorax. 67 (Suppl 2): A111.1–A111. doi:10.1136/thoraxjnl-2012-202678.395. S2CID 72695608.
  5. ↑ Danel, C.; Israël-Biet, D.; Costabel, U.; Klech, H. (1992). "Therapeutic applications of bronchoalveolar lavage". European Respiratory Journal. 5 (10): 1173–5. doi:10.1183/09031936.93.05101173. PMID 1486961. S2CID 6265382.
  6. ↑ Chen, Y; Lyu, X; Li, T; Wang, H (22 September 2023). "Impact of Whole Lung Lavage on Pneumoconiosis Patients - China, 2018-2022". China CDC Weekly. 5 (38): 844–848. doi:10.46234/ccdcw2023.160. PMC 10560373. PMID 37814649.
  7. ↑ Zeng Y, Jiang Y, Banks DE (August 2022). "The Effectiveness of Whole Lung Lavage in Pneumoconiosis: A Systematic Review and Meta-Analysis". J Occup Environ Med. 64 (8): e492–e499. doi:10.1097/JOM.0000000000002599. PMID 35732044. S2CID 249956633.
  8. ↑ Shrestha, D; Dhooria, S; Munirathinam, GK; Sehgal, IS; Prasad, KT; Ram, B; Singh, H; Aggarwal, AN; Puri, GD; Muthu, V; Agarwal, R (2022). "How We Do It: Whole Lung Lavage". Sarcoidosis, Vasculitis, and Diffuse Lung Diseases. 39 (2): e2022017. doi:10.36141/svdld.v39i2.12884. PMC 9437756. PMID 36118542.
  9. ↑ Mariani, Francesca; Salvaterra, Elena; Lettieri, Sara; De Silvestri, Annalisa; Corino, Alessandra; Bosio, Matteo; Fraolini, Elia; Piloni, Davide; Rodi, Giuseppe; Corsico, Angelo Guido; Campo, Ilaria (December 2022). "A mini-whole lung lavage to treat autoimmune pulmonary alveolar proteinosis (PAP)". Respiratory Research. 23 (1): 60. doi:10.1186/s12931-022-01982-2. PMC 8932062. PMID 35300687.
  10. ↑ Yang, Mingyuan; Li, Baoping; Wang, Bin; Li, Lei; Ji, Yurong; Zhou, Yunzhi; Huang, Rui; Cheng, Qinghao (December 2022). "Lung injury induced by different negative suction pressure in patients with pneumoconiosis undergoing whole lung lavage". BMC Pulmonary Medicine. 22 (1): 152. doi:10.1186/s12890-022-01952-w. PMC 9034602. PMID 35459122.


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