The benefits of whole lung lavage in pulmonary alveolar proteinosis

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Abstract
Successful treatment of PAP by therapeutic irrigation of the lungs was reported a few years after the disease was first described, and this led to massive whole lung lavage (WLL) 2, where, under general anaesthesia, the two lungs are separated by endobronchial intubation and one lung is ventilated while the other is flooded with warm saline to progressively wash out the alveolar space. Although there have been several refinements in this technique and developments in anaesthesia and peri-operative care, the basis of the treatment remains much the same 3–5.