pulmonary disorders
Pulmonary Alveolar Proteinosis
Treatment of Pulmonary Alveolar Proteinosis
Whole lung lavage Treatment of pulmonary alveolar proteinosis is unnecessary for patients without symptoms or for those with only mild symptoms. In patients with troubling dyspnea, whole lung lavage is done by using general anesthesia and a double-lumen endotracheal tube. Lavage of one lung is done up to 15 times with 1 to 2 L saline while the other lung is ventilated. The process is then reversed. Lung and Heart-Lung Transplantation is not often done because the disorder recurs in the transplanted lung. Systemic corticosteroids play no role in management and may increase the risk of secondary infection. The role of GM-CSF (inhalation or subcutaneous) in management remains to be determined. A multicenter, self-controlled, phase 2 trial at nine pulmonary centers in Japan showed an overall response rate of 62% (24/39) ( Treatment reference ). 1.Tazawa R, Trapnell BC, Inoue Y, et al. Inhaled granulocyte/macrophage-colony stimulating factor as therapy for pulmonary alveolar proteinosis.Am J Respir Crit Care Med2010;181(12):1345-1354. doi:10.1164/rccm.200906-0978OC 