Bronchopulmonary Lavage in Man

Publisher Website
Google Scholar
Abstract
A method for bronchopulmonary lavage in man is presented based on a complete filling of one lung with irrigating solutions while ventilating the other lung with 100% oxygen. A bronchospirometry tube was used to separate the ventilation of each lung. The alveolar nitrogen was removed by ventilating both lungs with 100% oxygen for 10 min. The lung selected for lavage was then partially degassed and filled to capacity with an isotonic saline solution containing heparin or 1% acetylcysteine. The lavage was produced by the patient actively inhaling and exhaling fluid with one lung while breathing 100% oxygen with the other. Twelve lavages have been performed on 6 patients. Measurements of the arterial blood gases showed that adequate oxygenation can be maintained throughout the procedure. Spilling of the irrigating solution in the contralateral lung was the most important complication. In 3 patients, an immediate favorable response to pulmonary lavage was observed. In 2 patients, one with alveolar proteinosis and the other with chronic asthmatic bronchitis, the oxygen tension 6 hr. after the lavage significantly exceeded that preceding it. The roentgenogram of 1 patient with alveolar proteinosis showed extensive clearing 24 hr. following the lavage. Bronchopulmonary lavage is proposed as an effective method of bron-chiolo-alveolar debridement. The experimental use of this method for the treatment of alveolar proteinosis and other pulmonary diseases associated with dysfunctions of the pulmonary clearing process is suggested.
Keywords