The Journal of the Japan Society for Respiratory Endoscopy
Online ISSN : 2186-0149
Print ISSN : 0287-2137
ISSN-L : 0287-2137
Lung Lavage Via the Bronchofiberscope as a Method of the Treatment for Pulmonary Alveolar Proteinosis
Rokuro MatsuokaHiroshi TakagiShiro Kira
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1983 Volume 5 Issue 4 Pages 385-392

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Abstract

Pulmonary alveolar proteinosis is a disease of unknown etiology characterized by the accumulation of proteinaceous material in the alveolar spaces. The aim of treatment in this disease is to facilitate the removal of proteinacious material from alveolar spaces. To accomplish this aim, we carried out lung lavage in 4 patients of alveolar proteinosis using the following three methods ; 1. selective unilateral lung lavage under general anesthesia, 2. simultaneous bilateral lung lavage with an extacorporeal membrane oxygenator, and 3. serial segmental broncho-alveolar lavage under local anesthesia with a bronchofiberscope, and compared their removal effect clinically, testing changes of chest X-ray findings, pulmonary function studies and arterial blood gas analysis. In Case 1, the three methods mentioned above were serially carried out during a 6 year period. In Case 2, method 3 was performed following treatment with method 2. In Cases 3 and 4, bronchoalveolar lavage with bronchofiberscope was repeated serially. The effect of treatment was satisfactory and essentially similar among these three methods. Therefore, it is preferable to select lung lavage with the bronchofiberscope as the treatment of first choice from the viewpoint of cost-effectiveness, its easy applicability and the disease characteristics of reaccumulation of proteinaceous material in alveolar spaces, although methods 1 and 2 are indispensable in the treatment of severely ill cases of this disease.

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© 1983 The Japan Society for Respiratory Endoscopy
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