Abstract

Pulmonary Alveolar Proteinosis (PAP) is a rare disease characterized by the accumulation of proteinaceous material in the alveoli, resulting in progressive hypoxemia and functional limitation. Whole lung lavage under general anesthesia with normal saline has become established as a safe and effective treatment for PAP. The technique varies slightly from institution to institution, but essentially involves the instillation and removal of 500-1000ml aliquots of normal saline from one lung at a time, which removes the offending material from the alveoli. There is often significant functional improvement within weeks that can persist for months or years. Repeat lavage can be done when symptoms return.